Solitary Abdominal Wall Lymph Node Recurrence in Prostate Cancer Patient with Dramatic Prostate-Specific Antigen Decrease following Metastasectomy.

Andrew Williams, Amr A Elbakry, Tyler Trump, Ion Prisneac, Matthew Smolkin, David Zekan, Mohamad W Salkini
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Abstract

Prostate cancer patients routinely undergo surveillance for recurrence using prostate-specific antigen (PSA). While PSA's benefit in screening is controversial, its use for detecting recurrence in patients with history of prostate cancer is pivotal. Rising PSAs with the newly advanced prostate-specific membrane antigen positron emission tomography (PSMA PET) can help localize the location of recurrences for better excision and management. Here, we present a 55-year-old with prostate cancer, with initially undetectable postprostatectomy PSA levels, who later presented with a PSA of 3.47 ng/mL. PSMA PET showed isolated uptake in an abdominal wall mass. Pelvic lymphadenectomy and abdominal wall mass excision were performed, confirming a single metastasis in an abdominal wall lymph node. Metastasectomy led to a dramatic drop in PSA to 0.10 ng/mL both postoperatively and on long-term follow-up. Our case illustrates the potential benefit of metastasis-directed therapy in delayed oligometastasis following definitive management of prostate cancer.

Abstract Image

Abstract Image

前列腺癌转移切除术后前列腺特异性抗原显著降低的孤立腹壁淋巴结复发。
前列腺癌患者常规接受前列腺特异性抗原(PSA)监测复发。虽然PSA在筛查中的益处存在争议,但其用于检测前列腺癌病史患者的复发是至关重要的。psa与最新的前列腺特异性膜抗原正电子发射断层扫描(PSMA PET)一起上升,可以帮助定位复发部位,以便更好地切除和治疗。在这里,我们报告了一位55岁的前列腺癌患者,前列腺切除术后PSA水平最初无法检测到,后来PSA为3.47 ng/mL。PSMA PET显示腹壁肿块孤立摄取。行盆腔淋巴结切除术和腹壁肿块切除术,证实腹壁淋巴结有单一转移。在术后和长期随访中,转移瘤切除术导致PSA急剧下降至0.10 ng/mL。我们的病例说明了转移导向治疗在前列腺癌最终治疗后延迟性少转移的潜在益处。
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