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Anak Agung Ngurah Oka Diatmika, Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya/ Dr. Soetomo General Academic Hospital, Surabaya
Sunaryo Hardjowijoto, Department of Urology, Faculty of Medicine, Universitas Airlangga, Surabaya/ Dr. Soetomo General Academic Hospital, Surabaya
Patricia Maria Kurniawati, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya
RR Indrayuni Lukitra Wardhani, Department of Physical Medicine and Rehabilitation, Faculty of Medicine, Universitas Airlangga/ Dr. Soetomo General Academic Hospital, Surabaya
Lucky Andriyanto, Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga, Surabaya
Arie Utariani, Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga, Surabaya
Nancy Margarita Rehatta, Professor of Anesthesiologist and Reanimation, Department of Anesthesiology and Reanimation, Faculty of Medicine, Universitas Airlangga, Dr. Soetomo Hospital, Surabaya,
Nur Lia F Darain, Faculty of Medicine, Universitas Airlangga, Surabaya
Ovitrani Nanda, Faculty of Medicine, Universitas Airlangga, Surabaya
Silvi Mavita, Faculty of Medicine, Universitas Airlangga, Surabaya
Usamah Usamah, Faculty of Medicine, Universitas Airlangga, Surabaya
Jongky Hendro Prajitno, Endocrine & Metabolism Division, Department of Internal Medicine, Faculty of Medicine & Dr. Soetomo General Hospital, Surabaya
Susi Wahyuning Asih, Department of Community Health Nursing, Faculty of Health Science, University of Muhammadiyah Jember
Zuhrotul Eka Yulis Anggraeni, Department of Paediatric Nursing, Faculty of Health Science, University of Muhammadiyah Jember
Ginanjar Sasmito Adi, Department of Medical and Surgical Nursing, Faculty of Health Science, University of Muhammadiyah Jember
Ely Rahmatika Nugrahani, Department of Mental Health Nursing, Faculty of Health Science, University of Muhammadiyah Jember
Ayesie Natasha Zulka, Department of Mental Health Nursing, Faculty of Health Science, University of Muhammadiyah Jember
Soetjipto Soetjipto, Department of Physiology and Medical Biochemistry, Faculty of Medicine, Universitas Airlangga, Surabaya

ORCID ID

Sunaryo Hardjowijoto: https://orcid.org/0000-0002-7811-7626

Abstract

A skeletal-related event (SRE) is an event occurring due to bone metastasis in prostate cancer. SREs are usually marked by pain, pathological fractures, spinal cord compression, hypercalcemia, or bone metastasis requiring radiotherapy or operation. Case I: A 64-year-old male was diagnosed with a pathological fracture of the left femur. Thoracal CT scan showed osteoblastic lesions in the thoracal vertebrae, sternum, clavicle, and humeral head. Spinal MRI showed destruction of the cervical to sacral vertebral bodies. The histopathological result with Adenocarcinoma Gleason scores 8 (4+4) and an initial prostate-specific antigen (PSA) level of 689,7 ng/dL. Afterward, subcapsular orchiectomy was performed. However, his PSA level was still high (>100 ng/dL) even after serum testosterone had reached a castration level. The patient died during the first chemotherapy using docetaxel. Case II: A 61-year-old male was diagnosed with inferior paraplegia and neurogenic bladder, paraparesis, urinary retention, and pain in the flank area. Spinal MRI showed a pathological compression fracture of the 8th thoracic vertebrae. Thoracal CT scan showed costal and 8th thoracal vertebrae destruction as well as multiple nodules in the lungs. Histological results with Adenocarcinoma Gleason score 9 (4+5) and an initial PSA level of 750 ng/dL. Afterward, subcapsular orchiectomy was performed. Serum testosterone reached castration level with the lowest PSA concentration of 21.6 g/dL. The patient declined chemotherapy and agreed to palliative treatment. He died one year after diagnosis. A high PSA level (>500 ng/dL) could potentially be used as a predictor for severe SRE.

First Page

250

Last Page

255

DOI

10.20473/fmi.v57i3.25250

Publication Date

9-5-2021

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