case_images: PMC10565221_01
case_images: Images of the patient throughout the treatment. (A) Before treatment, urinary tract CT showed a localized mass with mixed density in the pelvic region, unclearly displayed prostate and bladder, enlarged pelvic and retroperitoneal lymph nodes, and mildly dilated bilateral renal pelvis and ureter. (B) The postoperative pathological diagnosis showed prostate adenocarcinoma, Gleason score (GS) 5 + 4 = 9. (C) On 18 June 2020, prostate-enhanced MRI cross-sectional DWI showed an enlarged prostate with a maximum cross-sectional size of 50 x 37 mm, prostate cancer with invasion of the left pelvic sidewall and left side of the bladder, unclearly displayed bilateral seminal vesicles, and enlarged left external and internal iliac lymph nodes. (D) On 15 March 2021, prostate-enhanced MRI cross-sectional DWI showed an enlarged prostate with a maximum cross-sectional size of 50 x 37 mm and a significantly reduced volume of the prostate and left pelvic sidewall lesions compared to before treatment. (E) On 24 May 2021, prostate-enhanced MRI cross-sectional DWI showed a significantly increased lesion volume in the left pelvic sidewall and new metastasis in the left femoral neck, sacrum, and bilateral iliac crest. (F) On 17 November 2021, prostate-enhanced MRI cross-sectional DWI showed prostate with a maximum cross-sectional size of 37 x 29 mm and significantly reduced volume of lesion of prostate and left pelvic sidewall. Except for the left femoral neck, no bone metastases were found in the other parts of the body. (G) On 23 March 2022, prostate-enhanced MRI cross-sectional DWI showed that the volume of the lesion of the left pelvic sidewall was significantly increased, and rectal invasion was not ruled out. (H) On 8 September 2022, prostate-enhanced MRI cross-sectional DWI did not show new confirmed progression of imaging.
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case_images: PMC10565221_01_fonc-13-1185530-g001.jpg
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case_images: Urinary tract computed tomography (CT) on 14 December 2019, revealed a mass with mixed density in the pelvic region, unclearly displayed prostate and bladder, enlarged pelvic and retroperitoneal lymph nodes, and mildly dilated bilateral renal pelvis and ureter ( Figure 1A ). TURP plus transperineal biopsy of the prostate, and invasion of the left wall of the bladder was observed during the operation. The postoperative pathological diagnosis showed prostate adenocarcinoma, Gleason score (GS) 5 + 4 = 9 ( Figure 1B ). PSA level was unsatisfactory, dropping to only 7.04 ng/mL. Prostate-enhanced magnetic resonance imaging (MRI) on 18 June 2020 revealed an enlarged prostate with a maximum cross-sectional size of 50 x 37 mm, PCa with invasion of the left pelvic sidewall and left side of the bladder, unclearly displayed bilateral seminal vesicles, and enlarged left external and internal iliac lymph nodes ( Figure 1C ). PSA level of the patient dropped to 0.97 ng/mL. Prostate-enhanced MRI on 15 March 2021, suggested an enlarged prostate with a maximum cross-sectional size of 50 x3 7 mm and a significantly reduced volume of the prostate and left pelvic sidewall lesions compared to before treatment ( Figure 1D ). PSA level of the patient rose to 19.48 ng/mL. Prostate-enhanced MRI on 24 May 2021 revealed a significantly increased lesion volume in the left pelvic sidewall and new metastasis in the left femoral neck, sacrum, and bilateral iliac crest ( Figure 1E ). Except for the left femoral neck, no bone metastases were found in the other parts of the body ( Figure 1F ). In addition, prostate-enhanced MRI on 23 March 2022 revealed that the volume of the lesion on the left pelvic sidewall was significantly increased, and rectal invasion was not ruled out ( Figure 1G ). Full- body bone scan and prostate-enhanced MRI ( Figure 1H ) of follow-up did not show new confirmed progression of imaging.
case_images: The PSA and serum testosterone levels of the patient throughout the treatment. (A) Change in the PSA level after docetaxel chemotherapy, the first DR, and the second DR. (B) Change in the serum testosterone level.
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case_images: The changes in the PSA and serum testosterone levels throughout the treatment are shown in  Figure 2 .