Efficacy of total androgen blockade in metastatic prostatic carcinoma withtransient hypogonadotropic hypogonadism: A case report

A patient affected by metastatic prostatic carcinoma and hypogonadotropic h ypogonadism (HH) was treated with flutamide 750 mg/day plus an LH-RH analog . After confirmation of basal castration during treatment, he continued wit h antiandrogens alone. Following the normalization of gonadic function and subjective mild bone flare-up, the patient resumed the initial treatment an d obtained a partial response. When flutamide was interrupted because of li ver toxicity, the patient showed progressive disease in the bone, which was unresponsive to both flutamide resumption and salvage hormone therapy (bic alutamide). The patient is currently receiving chemotherapy with VP16 and e stramustine phosphate and is showing both serologic (PSA) and symptomatic r esponse. The interest of this case lies in the incidental detection of HH d uring therapy and in the responsiveness to treatment.