Disseminated, lethal prostate cancer during human immunodeficiency virus infection presenting with non-specific features. Open questions for urologists, oncologists, and infectious disease specialists.

摘要: Abstract Introduction: Prostate cancer is a very infrequent occurrence in persons aged 55 years or less, and it has been rarely reported HIV-infected patients (10 overall cases so far); therefore, an increased incidence compared with the general population not established, although younger age seems more frequent among HIV disease. Case report: We report case of metastatic prostate occurred 53-year-old man, admitted due to non-specific signs, symptoms: impaired conditions, fever, weight loss, fatigue, exertional dyspnea. A remarkable anemia aortic systolic murmur were prominent initial findings, while AIDS-related conditions suspected sustained CD4+ count contained viremia, which never required antiretroviral therapy. Repeated red blood cell transfusions empiric, combined antimicrobial therapy promptly carried out, under suspicion infectious endocarditis, but no appreciable improvement clinical was achieved. Subsequently, our patient complained only increasingly severe pain at root his left thigh, together overcoming dysuria urgency, also urinary tract infection that rapidly ruled out. During diagnostic workup for HIV-associated fever undetermined origin, bone marrow biopsy disclosed prostatic cancer, elevated specific antigen (PSA) acid phosphate levels. An abdominal–pelvic ultrasonography computerized tomographic scan allowed detect dyshomogeneous endopelvic expansive mass extrinsic compression bladder, involvement last lumbar vertebra, large portions pelvis, proximal epiphysis right femur. skeleton scintigraphy pointed out multiple hypercaptation (areas concentrated traces radioactivity) areas cranial, cervical, dorsal, lumbar, sacral vertebrae, as well pelvis upper both femurs. Despite therapeutic attempts, deceased after seven weeks overwhelming disseminated intravascular coagulation (DIC). Conclusions: The presentation (mimicking other generalized focal illnesses), final, lethal complication (DIC) pose striking problems related differential diagnosis during disease, rapid evolution into advanced, complicated, widely disease extensive invasion preceded appearance local signs–symptoms, DIC, deserves attention by specialists who care subjects.