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Perineal recurrence of prostate cancer six years after trans-perineal brachytherapy.

Eppinga W, Vijverberg P, Moerland R, Brand E, van der Voort van Zyp J, Noteboom J, van Vulpen M - J Contemp Brachytherapy (2014)

Bottom Line: We report a case of perineal recurrence of prostate cancer 6 years after low-dose-rate (LDR) brachytherapy for localized prostate cancer.The most common approach to treat such perineal masses, including those occurring after prior biopsy or surgery, is local excision.We report the use of stereotactic radiotherapy with volumetric modulated arc therapy (VMAT) as a novel non-invasive, potentially curative, and patient-friendly alternative to local excision.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, University Medical Center Utrecht, The Netherlands.

ABSTRACT
We report a case of perineal recurrence of prostate cancer 6 years after low-dose-rate (LDR) brachytherapy for localized prostate cancer. The most common approach to treat such perineal masses, including those occurring after prior biopsy or surgery, is local excision. We report the use of stereotactic radiotherapy with volumetric modulated arc therapy (VMAT) as a novel non-invasive, potentially curative, and patient-friendly alternative to local excision.

No MeSH data available.


Related in: MedlinePlus

T2-weighted image showing perineal metastasis between penile bulb and sphincter
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Figure 0001: T2-weighted image showing perineal metastasis between penile bulb and sphincter

Mentions: The patient recovered well from the procedure without relevant long-term toxicity. A PSA nadir of 0.11 ng/ml was reached 5 years afterwards. However, subsequently a gradual raise in PSA was noticed. At 6-years post-treatment, the PSA level was 4.3 ng/ml, and the PSA-doubling time (PSA-DT) was 14 months. An 11C-choline positron emission tomography (PET)/computed tomography (CT) (11C-choline PET/CT) followed by an MRI of the small pelvis revealed a perineal mass with a diameter of 14 mm just dorsally to the penile bulb (Fig. 1). Subsequent needle aspiration biopsy confirmed the diagnosis of recurrent prostate cancer. The position of the recurrence in the area of the brachytherapy needle tracts is most consistent with perineal seeding by one of the brachytherapy needles.


Perineal recurrence of prostate cancer six years after trans-perineal brachytherapy.

Eppinga W, Vijverberg P, Moerland R, Brand E, van der Voort van Zyp J, Noteboom J, van Vulpen M - J Contemp Brachytherapy (2014)

T2-weighted image showing perineal metastasis between penile bulb and sphincter
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4300357&req=5

Figure 0001: T2-weighted image showing perineal metastasis between penile bulb and sphincter
Mentions: The patient recovered well from the procedure without relevant long-term toxicity. A PSA nadir of 0.11 ng/ml was reached 5 years afterwards. However, subsequently a gradual raise in PSA was noticed. At 6-years post-treatment, the PSA level was 4.3 ng/ml, and the PSA-doubling time (PSA-DT) was 14 months. An 11C-choline positron emission tomography (PET)/computed tomography (CT) (11C-choline PET/CT) followed by an MRI of the small pelvis revealed a perineal mass with a diameter of 14 mm just dorsally to the penile bulb (Fig. 1). Subsequent needle aspiration biopsy confirmed the diagnosis of recurrent prostate cancer. The position of the recurrence in the area of the brachytherapy needle tracts is most consistent with perineal seeding by one of the brachytherapy needles.

Bottom Line: We report a case of perineal recurrence of prostate cancer 6 years after low-dose-rate (LDR) brachytherapy for localized prostate cancer.The most common approach to treat such perineal masses, including those occurring after prior biopsy or surgery, is local excision.We report the use of stereotactic radiotherapy with volumetric modulated arc therapy (VMAT) as a novel non-invasive, potentially curative, and patient-friendly alternative to local excision.

View Article: PubMed Central - PubMed

Affiliation: Department of Radiation Oncology, University Medical Center Utrecht, The Netherlands.

ABSTRACT
We report a case of perineal recurrence of prostate cancer 6 years after low-dose-rate (LDR) brachytherapy for localized prostate cancer. The most common approach to treat such perineal masses, including those occurring after prior biopsy or surgery, is local excision. We report the use of stereotactic radiotherapy with volumetric modulated arc therapy (VMAT) as a novel non-invasive, potentially curative, and patient-friendly alternative to local excision.

No MeSH data available.


Related in: MedlinePlus