Adenocarcinoma of the prostate is a major health concern in the United States, with 31,620 deaths estimated for 2019.1 A recent population-based study of nearly 400,000 patients found that radical prostatectomy (RP) was the most commonly utilized treatment in the United States for intermediate- and high-risk patients.2 In men under aged 70 in these risk groups, RP accounted for 48%-82% of first line therapy.2 These patients with intermediate- and high-risk disease represent the population most to be at high risk for recurrence following RP, historically defined by the presence of extracapsular extension, seminal vesicle involvement, or positive surgical margins.
A 73-year-old man underwent a 68Ga-PSMA-HBED-CC 11 PET/CT for evaluation of rising PSA in the context of previous radical retropubic prostatectomy and salvage radiotherapy for prostatic adenocarcinoma. There was no definite PSMA avid recurrence in the prostatic bed. Intense PSMA avid uptake was seen in the anterior aspect of the spleen. Further characterization with multiplanar multisequence pre- and post-IV contrast MRI of the upper abdomen with arterial, portal venous, and delayed phase acquisitions revealed a lesion with appearances consistent with a splenic hemangioma.
We report for the first time, a minimally invasive technique that avoids the need of VUA with favorable functional results.
CONCLUSIONS: The elevation of associated tumor markers (Ca 19.9, CEA) is extraordinary. There is no treatment algorithm, however surgery (radical prostatectomy) with or without adjuvant chemotherapy treatment represents an alternative in its therapeutic management. PMID: 31475675 [PubMed - in process]
Condition: Prostatic Adenocarcinoma Intervention: Sponsor: University Hospital, Brest Recruiting
Conditions: Prostate Cancer; Non-metastatic Prostate Cancer; Prostate Adenocarcinoma Interventions: Procedure: Radical therapy (radiotherapy or prostatectomy [radiotherapy can be external beam or brachytherapy]; Procedure: Focal therapy; Procedure: Focal therapy after Finasteride 5Mg tablets for 12 weeks; Procedure: Focal therapy after Bicalutamide 50Mg tablets for 12 weeks Sponsors: Imperial College London; Prostate Cancer UK; Imperial Clinical Trials Unit (ICTU) Not yet recruiting