leuprolide and Jaw-Diseases

S.R., a 65-year-old male with a history of prostate cancer, went to a cancer center in 2003. He had developed symptoms of bladder outlet obstruction in 1999 and was seen by a urologist. His baseline prostate-specific antigen (PSA) was 44 ng/ml. On physical examination, his prostate was enlarged, and a biopsy in January 2000 revealed adenocarcinoma with a Gleason score of 8. A metastatic workup, including a bone scan and a computed tomography scan of the abdomen and pelvis (CT A/P), was negative for evidence of metastatic disease. S.R. received conformal external beam radiation, and the luteinizing hormone-releasing hormone agonist leuprolide acetate was initiated. Following treatment, his PSA nadired to 0.2 ng/ml, and he did well until 2002, when his PSA started to rise. A reevaluation CT A/P revealed enlarged retroperitoneal and pelvic lymph nodes, and a bone scan was positive for metastatic disease. He underwent a bilateral orchiectomy in November 2002.

Topics: Adenocarcinoma; Aged; Androgen Antagonists; Antineoplastic Agents, Hormonal; Bone Density Conservation Agents; Combined Modality Therapy; Diphosphonates; Gonadotropin-Releasing Hormone; Humans; Imidazoles; Jaw Diseases; Leuprolide; Male; Orchiectomy; Osteonecrosis; Osteoporosis; Prostate-Specific Antigen; Prostatic Neoplasms; Radiotherapy, Conformal; Risk Factors; Tomography, X-Ray Computed; Zoledronic Acid