Shoeleh Celeste, Graff John, Patel Trushar
Department of Urology, University of South Florida, Tampa, USA.
Department of Pediatric Oncology, USF (University of South Florida) Health, Tampa, USA.
Cureus. 2023 Jun 4;15(6):e39948. doi: 10.7759/cureus.39948. eCollection 2023 Jun.
Despite the role of prostate-specific antigen (PSA) screening and the multitude of therapies available, prostate cancer (PCa) remains a leading cause of cancer-related morbidity and mortality. For many patients diagnosed with PCa, clinical and radiographic staging are critical components for management decisions. PCa staging with the use of imaging modalities such as MRI and bone scintigraphy is recommended in patients with newly diagnosed intermediate or high-risk PCa and in patients with biochemical recurrence; it is also recommended for monitoring the patient's response to treatment for diagnosed PCa. Prostate-specific membrane antigen (PSMA) positron emission tomography/computed tomography (PET/CT), recently approved in 2021, is an imaging modality that has been shown to have a greater sensitivity, specificity, and negative likelihood ratio than conventional imaging modalities such as CT, bone scintigraphy, and MRI in prostate cancer staging. Despite the improvement in staging that PSMA-PET/CT can provide, our current report details a false-negative result in detecting a rare PCa metastasis to the peritoneum, which was found at the time of an attempted radical prostatectomy. Although the patient had a negative preoperative PSMA-PET/CT and was presumed to be non-metastatic, the prostatectomy was aborted because the patient was unexpectedly found to have peritoneal metastasis.
尽管前列腺特异性抗原（PSA）筛查发挥了作用，且有多种治疗方法可供选择，但前列腺癌（PCa）仍然是癌症相关发病和死亡的主要原因。对于许多被诊断为PCa的患者而言，临床和影像学分期是管理决策的关键组成部分。对于新诊断为中危或高危PCa的患者以及生化复发的患者，建议使用MRI和骨闪烁显像等成像方式进行PCa分期；对于监测已诊断PCa患者对治疗的反应也建议进行分期。前列腺特异性膜抗原（PSMA）正电子发射断层扫描/计算机断层扫描（PET/CT）于2021年获得批准，是一种成像方式，在前列腺癌分期方面已显示出比CT、骨闪烁显像和MRI等传统成像方式具有更高的敏感性、特异性和阴性似然比。尽管PSMA-PET/CT能够在分期方面带来改善，但我们当前的报告详细阐述了在检测一例罕见的前列腺癌腹膜转移时出现的假阴性结果，该转移是在尝试进行根治性前列腺切除术时发现的。尽管该患者术前PSMA-PET/CT结果为阴性且被假定无转移，但由于意外发现患者存在腹膜转移，前列腺切除术被中止。
