When the Tumour Is Not the Culprit: Avascular Necrosis of the Hip in a Patient with Castration-Resistant Prostate Cancer

Chan, Esther; Chan, Grace; Ehrlich, Lisa; Hull, Pamela C.; Chu, William; Chow, Edward; Emmenegger, Urban

doi:10.3747/co.20.1206

Cited by 4 publications

(1 citation statement)

References 12 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Kemik yapıların kollabe olması sonucu; kemik yıkımı, ağrı ve eklem fonksiyon kaybı ile sonuçlanır. Prostat kanseri hastalarında AVN olgularının nadir görüldüğü bildirilmiştir (5 …”

Section: Introductionunclassified

Bilateral Avascular Necrosis and Pelvic Insufficiency Fractures Developing after Pelvic Radiotherapy in a Patient with Prostate Cancer: A Case Report

Sarı¹,

Örnek²,

Sucuoğlu³

et al. 2016

Tod

View full text Add to dashboard Cite

SummaryProstate cancer is one of the most common malignancies in men. Pelvic radiotherapy is commonly used in both radical and palliative treatment for prostate cancer. Radiation-induced adverse effects might be seen on adjacent healthy tissues (such as vessels, bones and soft tissues) with the exception of targeted area. Particularly several years after radiotherapy, low back and hip pain may occur due to bone edema, necrosis or fractures. In these cases, whether complaints due to the degenerative, metastatic or radiotherapy complications must be examined and appropriate treatment should be arranged. For this purpose, we present our elderly patient who received radiotherapy for prostate cancer, and thereafter, developed bilateral avascular hip necrosis and pelvic insufficiency fractures. Keywords: Prostate cancer, radiotherapy, pelvic, insufficiency fracture, avascular necrosis Prostat Kanseri Radyoterapisi Sonrası Gelişen Femur Başı Avasküler Nekrozu ve Pelvik Yetersizlik Kırığı Olgusu Bilateral Avascular Necrosis and Pelvic Insufficiency Fractures Developing after Pelvic Radiotherapy in a Patient with Prostate Cancer: A Case ReportProstat kanseri, erkeklerde en sık görülen malignitelerden biridir. Pelvik radyoterapi, radikal veya palyatif prostat kanseri tedavisinde yaygın olarak kullanılmaktadır. Radyoterapi, hedef kanser bölgesi dışındaki komşu sağlam dokularda (damar, sinir, kemik gibi) komplikasyonlar meydana getirebilir. Özellikle radyoterapiden yıllar sonra ortaya çıkabilen kemiklerde ödem, nekroz veya kırıklara bağlı bel ve kalça ağrıları meydana gelebilir. Bu olgularda şikayetlerin dejeneratif, metastatik veya radyoterapi komplikasyonuna mı bağlı olduğu tetkik edilmeli ve tedavi buna göre düzenlenmelidir. Biz de bu amaçla, prostat kanserinde pelvik radyoterapi uygulanan ve buna bağlı bilateral kalça avasküler nekrozu ve pelvik yetersizlik kırıkları gelişen yaşlı erkek hastamızı sunuyoruz.

show abstract

Section: Introductionunclassified

Bilateral Avascular Necrosis and Pelvic Insufficiency Fractures Developing after Pelvic Radiotherapy in a Patient with Prostate Cancer: A Case Report

Sarı¹,

Örnek²,

Sucuoğlu³

et al. 2016

Tod

View full text Add to dashboard Cite

show abstract

Rectal Cancer

Stephens¹,

Willett²,

Czito³

et al. 2017

Practical Guides in Radiation Oncology

View full text Add to dashboard Cite

Docetaxel/steroids/zoledronic acid

2013

Reactions Weekly

View full text Add to dashboard Cite

S Docetaxel/steroids/zoledronic acid Avascular necrosis of the hip in an elderly patient: case reportA 79-year-old man with prostate cancer developed avascular necrosis (AVN) of the hip during treatment with docetaxel, zoledronic acid, and the steroids hydrocortisone, dexamethasone, and prednisone [not all routes and dosages stated; durations of treatments to reaction onset not clearly stated].The man was diagnosed at the age of 75 years with prostate adenocarcinoma. He underwent radiation therapy and received androgen deprivation therapy (ADT) 2 years later. The response to ADT was short-lived and he was treated with oral hydrocortisone 30mg daily combined with ketoconazole. However, this had a limited impact on disease progression. Four years after his initial diagnosis, he began treatment with docetaxel chemotherapy. The regimen was every 3 weeks and included premedication with three 8mg doses of oral dexamethasone, and oral prednisone 5mg twice-daily continuously. This was accompanied by zoledronic acid. After ten cycles of docetaxel, he decided on a treatment break and a prednisone taper due to concerns of early cushingoid facies and increasing fatigue after the chemotherapy. Two months after his last docetaxel dose, he presented with right hip pain and lower back pain. He also had a rapid increase in prostatespecific antigen (PSA). His prednisone was reinstated and he received palliative radiation therapy. He was admitted 2 weeks later with treatment-refractory right hip pain, difficulty ambulating, and right leg swelling. He was treated with morphine and was discharged. He began chemotherapy and after an additional six cycles of docetaxel, bone scintigraphic restaging showed a change in the configuration of his right hip. CT imaging and radiography revealed near-complete resorption of his right femoral head and superior displacement of his right femur. The clinical presentation was unequivocal for advanced AVN of the femoral head.The man opted against hip replacement surgery, considering the absence of relevant pain under morphine, his limited life expectancy, his acceptable quality of life, and the prospect of prolonged rehabilitation.

show abstract

When the Tumour Is Not the Culprit: Avascular Necrosis of the Hip in a Patient with Castration-Resistant Prostate Cancer

Cited by 4 publications

References 12 publications

Bilateral Avascular Necrosis and Pelvic Insufficiency Fractures Developing after Pelvic Radiotherapy in a Patient with Prostate Cancer: A Case Report

Bilateral Avascular Necrosis and Pelvic Insufficiency Fractures Developing after Pelvic Radiotherapy in a Patient with Prostate Cancer: A Case Report

Rectal Cancer

Docetaxel/steroids/zoledronic acid

Contact Info

Product

Resources

About