case_images: PMC10959003_01
case_images: Schematic representation of the patient's treatment history. (A) Treatment timeline. (B) Genome sequencing and IHC performed on the biopsies throughout the disease course. PCa, Prostate Cancer; RARP, Radical prostatectomy; ADT, adrenal deprivation therapy; PD, progression disease; mHNPC, metastatic hormone naive prostate cancer; mCRPC, metastatic castration-resistant prostate cancer; LNDs, lymph nodes; NGS, Next generation sequencing; WES, whole genome sequencing; WGS, whole genome sequencing; IHC, immunohistochemistry.
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case_images: PMC10959003_01_fonc-14-1331643-g001.jpg
case_images: f1
case_images: The original TP53 mutation detected in the primary tumor (p.I195F) was also detected, confirming the common origin ( Figure 1 ).
case_images: Serum bone biomarkers values (ALP, LDH, and PSA) and CT scans before and after third line with Radium-223 treatment, throughout the disease course. ALP, alkaline phosphatase; LDH, lactic acid dehydrogenase; PSA, Prostate-specific antigen; CT, computed tomography.
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case_images: PMC10959003_01_fonc-14-1331643-g002.jpg
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case_images: Progression was documented with new bone metastases confirmed on Bone and CT scans: an osteolytic bone metastasis with a soft tissue component in the right ileopubic ramus and an osteoblastic bone metastasis in the right ischiopubic ramus ( Figure 2 ).
case_images: Histological morphology on H&E stains and IHC characteristics of FFPE section of a primitive prostate biopsy, metastatic bone biopsy and metastatic lymph node biopsy from Prostate Cancer adenocarcinoma. (A-I, K-N). magnification 200X. (J) magnification 100X. HE, Haematoxylin and Eosin; IHC, Immunohistochemistry; PSA, Prostate specific antigen; AR, Androgen Receptor.
case_images: fonc-14-1331643-g003.jpg
case_images: PMC10959003_01_fonc-14-1331643-g003.jpg
case_images: f3
case_images: April 2019. A biopsy on the right ileopubic bone lesion was performed prior to the imaging evaluation, confirming the presence of prostate adenocarcinoma cells, with a strong expression in IHC (immunohistochemistry) of Androgen receptor (AR) and NKX3.1, a weak expression of PSA and the negativity of neuroendocrine markers (Chromogranin A, CD56) ( Figure 3 ). IHC assessment of the lymph node revealed a strong expression of AR and NKX3.1, and weak expression of PSA (in line with the low PSA levels in serum) and negativity for neuroendocrine markers Chromogranin A and CD56 ( Figure 3 ).