Successful Diagnosis and Treatment of Occult Prostate Cancer Despite Multiple Negative Prostate Biopsies and Negative Prostate MRIs.

Abstract

Prostate-specific antigen (PSA) values above 100 ng/mL often suggest metastatic prostate cancer. We present the case of a patient with a PSA of 110 ng/mL, 4 negative prostate biopsies, and 4 negative prostate MRIs. After his fifth MRI revealed a PI-RADS 5 lesion, he underwent his fifth transrectal biopsy; this revealed Gleason 3 + 4 = 7. He was found to have organ-confined pT2 disease on subsequent radical prostatectomy pathology. This case highlights that there may be no PSA for which one can assume metastatic disease with certainty. Depending on life expectancy, patients with extremely elevated PSA may still warrant a full staging workup.

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Published Version (Please cite this version)

10.46883/25920952

Publication Info

Morris, Kostantinos E, Dominic C Grimberg, Rajan T Gupta, Avani A Pendse and Judd W Moul (2022). Successful Diagnosis and Treatment of Occult Prostate Cancer Despite Multiple Negative Prostate Biopsies and Negative Prostate MRIs. Oncology (Williston Park, N.Y.), 36(3). pp. 178–183. 10.46883/25920952 Retrieved from https://hdl.handle.net/10161/24771.

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Scholars@Duke

Gupta

Rajan Tilak Gupta

Professor of Radiology

Abdominal Imaging; Multiparametric MR imaging of prostate cancer; MR imaging of the hepatobiliary system; Applications of dual energy CT in the abdomen and pelvis

Pendse

Avani Anil Pendse

Associate Professor of Pathology

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