Urologie pro praxi 2/2021

Progression of prostate cancer after radical prostatectomy despite undetectable PSA levels

Currently, prostate cancer is the third most common cancer disease in men in the Czech Republic and the second most common tumour found in men worldwide. Its incidence increases annually. Every year, diagnostic and treatment algorithms for prostate cancer are updated which take into account the rate of local tumour progression, its grade of histological differentiation, and the degree of metastatic spread. In the case of prostate cancer, the skeleton alone or the skeleton in combination with metastatic involvement of the iliac and/or para-aortic nodes are the most common sites of distant metastases. So far, only a small number of lung metastases of prostate cancer have been reported in the literature; in addition, they typically presented synchronously with bone metastases. Moreover, their occurrence correlated with an aggressive histological tumour subtype (a Gleason score of 8 and higher) and PSA elevation. This case is rare due to the fact that a solitary lung metastasis of prostate cancer was found in a patient with undetectable PSA levels and a Gleason score of 6 with exclusion of generalization to other sites.

Keywords: prostate cancer, radical prostatectomy, solitary lung metastasis, undetectable PSA levels, generalization, robotic radical prostatectomy.