Palabras clave
Neoplasias de la próstata
Metástasis de la neoplasia
Adenocarcinoma
Carcinomatosis peritoneal
Cómo citar
Resumen
La carcinomatosis peritoneal es una entidad poco común y de mal pronóstico, evidenciada en metástasis principalmente de origen gastrointestinal y ovárico. Sin embargo, es infrecuente que se desarrolle por adenocarcinoma prostático. Se presenta el caso de un adulto mayor con síndrome constitucional asociado a ascitis maligna, de dos meses de evolución. La tomografía reveló múltiples lesiones peritoneales correspondientes a carcinomatosis peritoneal. En el tacto rectal, una próstata fija y pétrea con recesos bilaterales comprometidos. El antígeno prostático específico estaba marcadamente elevado. La biopsia de las lesiones peritoneales confirmó adenocarcinoma prostático avanzado, T4N0M1, estadio IVb, Gleason X. Se realizó bloqueo androgénico completo y el paciente continúa en seguimiento a los 24 meses. La carcinomatosis peritoneal por carcinoma prostático es un diagnóstico diferencial que debe plantearse ante ascitis y patología tumoral prostática, siendo la sospecha clínica y los estudios citoquímicos el inicio del abordaje secuencial para un diagnóstico oportuno, estadificación tumoral y pronóstico.
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