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A Cognitive Fusion-guided Prostate Biopsy Using Multiparametric Magnetic Resonance Imaging and Transrectal Ultrasound

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Prostate cancer with elevated free prostate-specific antigen density: A case report.

Deng-Hui Huang¹, Yun-Xi Hu¹, Shuang Guo¹

¹Department of Urological Surgical, Wenshang County People's Hospital, Jining 272500, Shandong Province, China.

World Journal of Clinical Cases

|June 20, 2024

Summary

This case study highlights prostate cancer in a patient with normal total prostate-specific antigen (tPSA) but elevated free PSA density (fPSAD). This finding offers a clinical reference for diagnosing and treating similar cases.

Keywords:

Case report Free prostate-specific antigen density Prostate cancer Total prostate-specific antigen

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Area of Science:

Oncology
Urology
Biochemistry

Background:

Prostate cancer is a prevalent malignancy in men globally.
Prostate-specific antigen (PSA) is a key biomarker for prostate cancer screening.
Elevated total PSA (tPSA) typically indicates potential prostate cancer, while normal levels often suggest its absence.

Observation:

A patient initially diagnosed with benign prostatic hyperplasia underwent prostatectomy.
Postoperative pathology revealed acinar adenocarcinoma of the prostate.
The patient presented with a normal tPSA level but an elevated free PSA density (fPSAD).

Findings:

The case demonstrates prostate cancer can occur despite normal tPSA levels.
Elevated fPSAD can be a critical indicator in such scenarios.
This challenges the conventional interpretation of tPSA in prostate cancer screening.

Implications:

This case provides a valuable clinical reference for diagnosing and managing prostate cancer.
It underscores the importance of considering fPSAD in conjunction with tPSA for accurate diagnosis.
Further research may refine PSA-based screening protocols to include fPSAD for improved detection rates.