PMC8766302_01
(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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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).
(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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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).
The clinical treatment course and prostate-specific antigen response.
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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).