Korean J Med.  2015 Aug;89(2):238-242. 10.3904/kjm.2015.89.2.238.

Recurrent Prostate Cancer Presenting as Multiple Lung Metastases with a Low Serum Prostate-specific Antigen Level 5 Years after Prostatectomy: A Case Report

• Ko YM
• Lee JE
• Yoo JY
• Park J
• Roh SY

• KMID: 2269037
• DOI: http://doi.org/10.3904/kjm.2015.89.2.238

Abstract

Prostate-specific antigen (PSA) is a glycoprotein produced by prostatic duct and acinar epithelial cells and the most commonly used marker for diagnosing prostate cancer, and for monitoring its progression and recurrence. Here, we describe a 76-year-old patient with recurrent prostate cancer who developed isolated hematogenous pulmonary metastases with a normal serum PSA level 5 years after radical prostatectomy. Immunohistochemical (IHC) analysis of a transbronchial lung biopsy specimen revealed tumor cells positive for PSA and prostatic acid phosphatase. After 2 months of maximal androgen blockade, the metastatic pulmonary nodules showed near-complete regression. In conclusion, metastases of prostate adenocarcinoma may occur despite low serum PSA levels, and, if warranted clinically, IHC staining or other serological markers for prostate adenocarcinoma should be considered when evaluating metastatic carcinoma from an unknown primary lesion in males with low serum PSA levels.

Keyword

Prostate cancer; Metastasis; Prostate-specific antigen

MeSH Terms

Acid Phosphatase
Adenocarcinoma
Aged
Biopsy
Epithelial Cells
Glycoproteins
Humans
Lung*
Male
Neoplasm Metastasis*
Prostate*
Prostate-Specific Antigen*
Prostatectomy*
Prostatic Neoplasms*
Recurrence
Acid Phosphatase
Glycoproteins
Prostate-Specific Antigen