Radioguided Pelvic Lymphadenectomy - The Rescue in Recurrence Prostate Cancer - one New Tool for Detection of Metastases - Abstract
Background: The prostate cancer is the most common tumor in man, and even after the initial therapy an important part of the affected population also presents recurrence of the tumor. The identification of metastasis sites through this nuclear medicine exam allows the extrapolation of its use, previously only diagnostic, to still act as an experimental model in the therapeutic field
Methodology: Case report of a 79 years old patient with a initial serum PSA 9.4 was diagnosed with prostate cancer with a biopsy showing a Gleason 7 (3+4). He underwent a radical prostatectomy with standard lymphadenectomy in 2010. It evolves uneventfully until in 2014 a biochemical recurrence was diagnosed and was then submitted to salvage radiotherapy. After 2 years of radiotherapy, he returned to have a new elevation of PSA and a PET-PSMA, which showed pelvic lymph node enlargement. He was submitted in an experimental protocol of radioguided pelvic lymphadenectomy with PSMA - 99mTc.
Conclusion: Although it is a recent technology, radioguided surgery is an effective way to identify small metastases in patients undergoing salvage lymphadenectomy, helping the surgeon to detect diseased lymph nodes and not adding morbidity and mortality to the procedure