Metastatic prostate cancer to lung with normal prostate specific antigen levels

Abstract

A 77-year-old man presented with significant lower urinary tract symptoms, complaining of urinary frequency and poor flow. He had a normal feeling prostate. A cystoscopy was unremarkable apart from a polyp in the prostatic urethra that was biopsied. Histology revealed adenocarcinoma of the prostate, Gleason combined grade 8 (4+4). Transrectal ultrasound and biopsy was performed confirming adenocarcinoma in three of six cores. A bone scan and a computed tomography (CT) scan revealed no evidence of metastatic disease. Several weeks post cystoscopy his prostate specific antigen (PSA) level was raised at 8.1μg/litre (normal <4.0 μg/litre); however, this settled 2 weeks later at..