Prostatic carcinoma presenting with respiratory symptoms: response to orchidectomy.

Accepted 24 March 1984 gestive of interstitial lung disease. The serum acid phosphatase was 48-4 U/I (normal range 0-4 U/i). Respiratory function tests showed a restrictive pattern (table). At bronchoscopy the mucosa was reddened but no endobronchial lesion was seen. Transbronchial biopsy showed aggregates of small polyhedral cells thought to be well differentiated adenocarcinoma with invasion of subpleural lymphatics (fig 2). Trucut perineal biopsy of the prostate yielded material which showed invasive well differentiated adenocarcinoma. An isotope bone scan showed multiple bone metastases. Bilateral subcapsular orchidectomy was performed. The patient' s shortness of breath improved dramatically over the next four months. Serum acid phosphatase activity fell to 11-4 U/I. The chest radiograph showed complete clearing of the widespread shadowing. Lung volumes and transfer factor were almost normal four months after orchidectomy and the patient remains well eight months after operation.