PMC8635688_01
Timeline.
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Radical prostatectomy was performed with lymphadenectomy, confirming Gleason 8 (4 + 4) prostate adenocarcinoma invading the seminal vesicles (cT3bN0M0) ( Figure 1 ).
MRI liver revealed two metastases: (A) in segment VII and (B) straddling segments V and VI.
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B = a 20-mm lesion involving both segments V and VI) ( Figure 2 ). Biopsy confirmed prostate adenocarcinoma without any neuroendocrine differentiation ( Figure 3 ).
Histopathology findings of liver biopsy lesions confirming prostatic origin with cribriform pattern (A). Positive staining for PSA (B). Hematoxylin and eosin stain (x20) (C).
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B = a 20-mm lesion involving both segments V and VI) ( Figure 2 ). Biopsy confirmed prostate adenocarcinoma without any neuroendocrine differentiation ( Figure 3 ).
Dose distribution of the stereotactic body of radiotherapy (50 Gy in five fractions) of lesion (B) (coils) post radiofrequency of lesion (A).
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The limited number of liver lesions, the well-circumscribed aspect of these lesions, the absence of any other visible lesion, and the absence of a more pronounced radiological response led us to consider MDT in addition to ADT and AA-P; in August 2016, microwave needle ablation was performed on lesion A, and 4 weeks later, we performed SBRT (50 Gy in 5 fractions of 10 Gy) on lesion B that was less accessible to radiofrequency ( Figure 4 ).