Abstract
We present a rare case of perineal recurrence of prostate cancer post low dose rate brachytherapy. Increased levels of prostate-specific antigen were recorded 12 years post brachytherapy. Pelvic CT and MRI visualized a nodular lesion in the perineum, and positron emission tomography demonstrated choline-avidity. Ultrasound-guided biopsy of the nodule was performed, yielding histology consistent with prostatic adenocarcinoma. Metastatic prostatic seeding to the perineum is a rare complication of brachytherapy. We discuss the putative mechanism, approach to diagnosis, and management.
Highlights
Investigations/Imaging findings MRI of the prostate was performed including dynamic contrast-enhanced (DCE) imaging, which failed to identify tumour for targeted biopsy
The prostatic capsule and periprostatic fat planes were clear of metastatic spread
Brachytherapy seeds are present in the prostate gland in (B)
Summary
Investigations/Imaging findings MRI of the prostate was performed including dynamic contrast-enhanced (DCE) imaging, which failed to identify tumour for targeted biopsy. Case report: Perineal recurrence of prostate cancer post-brachytherapy Figure 3.
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