PMC5148773_01
MRI liver protocol showing a 5.3 x 5.0 cm mass centered in the left lateral hepatic segment, not seen on previous scans. The center of this mass demonstrates even higher T2 and low T1 signal without obvious enhancement, which may reflect necrosis. There is a rind of heterogeneous hypervascularity around the periphery of this mass. (A) Axial section (B) Coronal section.
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Follow-up MRI liver showed a 5.3 x 5.0 cm mass in the left lateral hepatic segment with heterogeneous hypervascularity surround the periphery of the mass (Fig. 1).
(A) This slide (400x total magnification) demonstrates the cytologic atypia with some larger nuclei and irregular nuclear contours. There are prominent nucleoli. (B) Immunohistochemical staining with PIN4 highlights the tumor cells with the racemase portion of the stain (red). Together with the histology, this is diagnostic of metastatic prostate adenocarcinoma.
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He underwent biopsy of the liver mass, and pathology showed metastatic prostate carcinoma (Fig. 2).
Demonstrates the decline in PSA level following surgical resection of isolated liver metastasis. PSA decreased from 48 (dot) to less than 0.01 (asterix).
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His post-operative PSA decreased to < 0.01 from 48 (Fig. 3).