A case of solitary lung metastasis detected from PSA recurrence after radical prostatectomy for prostate cancer

Sato Shuji, Inagaki Takuya, Okamoto Tomoyoshi, Ohtsuka Takashi

doi:10.2995/jacsurg.36.815

<p>An 82-year-old man underwent radical total prostatectomy for prostate cancer (pT3aN0M0, Gleason score 3+4) at the age of 75. The preoperative serum PSA level was high at 6.71 ng/mL, but the postoperative level was maintained below 0.1 ng/mL. However, at four years and eight months postoperatively, his PSA rose to 0.27 ng/mL, so he was diagnosed with PSA recurrence. At five years and nine months postoperatively, simple chest computed tomography (CT) revealed a 10-mm nodule in the right lower lobe. At seven years and two months postoperatively, the nodular shadow had increased to 14 mm, which was considered an indication for surgery. The first suspicion was lung metastasis of prostate cancer, but considering the possibility of primary lung cancer, a thoracoscopic right lower lobectomy and lymph node dissection (ND2a-1) were performed. Histopathology showed adenocarcinoma morphology, and immunohistochemical staining was positive for PSA, leading to the diagnosis of lung metastasis from prostate cancer.</p><p>Although solitary lung metastasis from prostate cancer is rare, monitoring the serum PSA level is useful for its detection, and it is important to suspect lung metastasis on observing lung nodules that appear after radical total prostatectomy, with a PSA of 0.2 ng/mL or higher as PSA recurrence.</p>

A case of solitary lung metastasis detected from PSA recurrence after radical prostatectomy for prostate cancer

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