Authors
Yuki Shimoma, Kento Morozumi, Yuki Seki, Yasuki Endo, Marino Sawai, Hiroki Kusumoto, Masaaki Oikawa, Yasuhiro Kaiho
Published in
Nihon Hinyokika Gakkai zasshi. The japanese journal of urology. Volume 117. Issue 4. Pages 123-127.
Abstract
(Background) Although radical prostatectomy is a curative treatment for localized prostate cancer, some high-risk patients experience early recurrence due to occult metastases undetected by conventional imaging. (Case presentation) A 53-year-old man with high-risk prostate cancer (cT2bN0M0, Gleason score 4+4, initial PSA 10.6 ng/mL) underwent robot-assisted radical prostatectomy with pelvic lymph node dissection. Pathology revealed Gleason score 4+5, pT3bN1 disease. At 1 month postoperatively, PSA increased to 13.6 ng/mL, and whole-body MRI detected a solitary right iliac bone metastasis that had not been identified preoperatively. (Intervention) Based on early recurrence, high Gleason grade, and good performance status, triplet therapy with androgen deprivation therapy, darolutamide, and docetaxel was initiated. (Outcome) PSA decreased to undetectable levels, and follow-up imaging demonstrated marked regression of the bone metastatic lesion. (Conclusion) This case highlights the clinical utility of whole-body MRI for detecting early metastatic recurrence after radical prostatectomy and suggests that early identification of occult metastasis may allow timely intensification of systemic therapy, including triplet therapy, in selected high-risk patients.
PMID:
42907350
Bibliographic data and abstract were imported from PubMed on 23 Oct 2026.
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