Background: Many factors could contribute to the cases of residual benign prostate hypertrophy (BPH) volume after transurethral resection of the prostate (TURP), such as age, obesity, testosterone level, and inflammation. The goal of this study was to determine the risk of tumor necrosis factor-α (TNF-α), transforming growth factor-β (TGF-β) in prostate tissue, serum prostate-specific antigen (PSA), serum testosterone, and age in promoting prostate volume progression after TURP. Patients and Methods: This was a prospective cohort study on 83 BPH patients who underwent TURP at five hospitals in Bali, Indonesia. Trans-rectal ultrasonography (TRUS) was carried out to examine the prostate's size. Three years after, we redo the TRUS examination to collect the data of the latest prostate size. TNF-α, TGF-β, serum PSA, testosterone, and age were registered for analysis. We used Pearson's and Spearman's correlation tests and multivariate analytic linear regression test (coefficient β) by SPSS 13.0 software. Results: Age, testosterone, PSA, TNF-α, TGF-β were positively correlated to prostate's volume progression. The prostate volume was strongly correlated with age (r= 0.749, p <0.001), PSA level (r=0.896, p <0.001), testosterone level (r=0.818, p <0.001), and TGF-β (r=0.609, p <0.001). The TNF-α level has a weak correlation to prostate's volume progression (r=0.392, p <0.001). Conclusion: TNF-α, TGF-β, PSA, testosterone, and age were significant as the risk factors in promoting the prostate volume progression after TURP.
Cystosarcoma phyllodes was described first in 1838 and originally was considered to be a benign tumor. It was not until 1931 that metastasis from a cystosarcoma phyllodes was reported. The incidence of cystosarcoma phyllodes is estimated to be 0.3% to 0.9% of all breast tumors. Sites most commonly affected by metastases are the lungs and bones. We present a case report 29-year old female patient presented with a voluminous breast mass at both of them which was completely resected. The right side presented of malignant phyllodes and the left side is borderline phyllodes. Six months later, both of her legs became paralyzed and accompanied by swelling over her right upper arm. Biopsy was performed, and the diagnosis was metastatic malignant phyllodes tumor. Histologic review of the breast tumor revealed stromal overgrowth.
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