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1/2. prostate cancer in klinefelter syndrome during hormonal replacement therapy.

    prostate cancer detection is a rare occurrence in patients with klinefelter syndrome, in whom chronically low circulating androgen levels are common findings. Administration of exogenous testosterone has increasingly been used to treat young adolescents diagnosed with klinefelter syndrome and documented androgen deficiency. Although testosterone replacement in adult patients has been associated with prostatic enlargement, it remains unknown whether chronic supplementation of exogenous testosterone to pubescent males with hypogonadism results in early prostate carcinogenesis. We report a first case of prostate cancer in a patient with klinefelter syndrome who had undergone long-term testosterone replacement therapy since childhood for chronically depressed levels of testosterone.
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ranking = 1
keywords = androgen
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2/2. The development of prostate cancer despite late onset androgen deficiency.

    Androgen withdrawal causes the regression of prostate cancer and is used in therapy, but the role of androgens in the development of prostate cancer is uncertain. We present a case of prostate cancer diagnosed in a man who had been clinically androgen deficient for some years. This case and reviewed literature suggest that while early androgen exposure may be important in the prostatic carcinogenesis, late onset androgen deficiency is not protective. Thus, hypogonadal men considering androgen replacement therapy need to be adequately counseled, screened for prostate cancer and followed closely during treatment.
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ranking = 4.5
keywords = androgen
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