case_images: PMC8766302_01
case_images: (A) Histology of transurethral resection specimens and radical prostatectomy specimens. (B) Immunohistochemistry of transurethral resection specimens showed very strong expression of P504S, middle expression of PSAP, and focal positivity for PSA.
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case_images: Pathological examination and immunohistochemistry of the tumor tissue from transurethral resection demonstrated that it was PCa adenocarcinoma with a Gleason score 10 (5 + 5) (Figures 1A, B). The surgical pathology revealed that it was prostate adenocarcinoma, with reduced tumor stage of IIIB (ypT3b, N0, cM0) (Figure 1A).
case_images: (A) PSMA-PET/CT scans suggested of uneven increase in PSMA expression of prostate. (B) PSMA-PET/CT scans showed shrunken lesions after platinum-based neoadjuvant chemotherapy.
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case_images: Results of prostate-specific membrane antigen (PSMA)-PET/CT scan showed a high level of asymmetrical PSMA uptake in the prostate, confirming invasion of the seminal vesicle and rectum (Figure 2A). Furthermore, PSMA-PET/CT scan found that the lesions obviously shrank (Figure 2B).
case_images: The clinical treatment course and prostate-specific antigen response.
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case_images: Due to NGS detection of several somatic pathogenic mutations in the HR pathway, he participated in a clinical trial (NCT04869371) and commenced on androgen deprivation therapy (ADT) plus platinum-based neoadjuvant chemotherapy (docetaxel 75 mg/m2 plus cisplatin 130 mg/m2) on October 11, 2019 (Figure 3). At final follow-up (June 3, 2021), his PSA was still undetectable (<0.008 ng/ml) with normal level of testosterone, and no imaging progression was found by electroconvulsive therapy (ECT) and MRI scan (Figure 3).