eISSN: 2081-2841
ISSN: 1689-832X
Journal of Contemporary Brachytherapy
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6/2020
vol. 12
 
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abstract:
Case report

Perineal recurrence of prostate ductal adenocarcinoma after transperineal brachytherapy: a case report and literature review

Takashi Fukagai
1
,
Kidai Hirayama
1
,
Masashi Morita
1
,
Kota Nishimura
1
,
Jin Yamatoya
1
,
Tetsuo Noguchi
1
,
Yu Ogawa
1
,
Atsushi Igarashi
1
,
Madoka Morota
2
,
Masako Kato
3
,
Kazuhiko Oshinomi
4
,
Yoshio Ogawa
4
,
Toyonori Tsuzuki
5

  1. Department of Urology, Showa University Koto Toyosu Hospital, Tokyo, Japan
  2. Department of Radiation Oncology, Showa University Koto Toyosu Hospital, Tokyo, Japan
  3. Division of Radiation Oncology, Department of Radiology, Showa University School of Medicine, Tokyo, Japan
  4. Department of Urology, Showa University School of Medicine, Tokyo, Japan
  5. Department of Surgical Pathology, Aichi Medical University, Nagakute, Aichi, Japan
J Contemp Brachytherapy 2020; 12, 6: 612–617
DOI: https://doi.org/10.5114/jcb.2020.101696
Online publish date: 2020/12/18
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Perineal recurrence after brachytherapy is an exceedingly rare complication. Moreover, ductal adenocarcinoma is a rare histological variant of prostate cancer. Herein, we describe a case of perineal recurrence from ductal adenocarcinoma of prostate after low-dose-rate brachytherapy (LDR-BT) in a 65-year-old male patient. The patient had localized prostate cancer, for which he received LDR-BT; however, he experienced perineal recurrence 2 years after receiving LDR-BT. Surgical excision was attempted, but we were unable to remove the whole tumor, owing to invasion to surrounding tissue. Pathological examination of resected tumor showed ductal adenocarcinoma of the prostate. External beam radiation therapy and high-dose-rate brachytherapy (HDR-BT) were performed for residual tumor. Mild mediastinal lymph node swelling was observed during clinical course of the disease. Hence, androgen deprivation therapy was administered with abiraterone after radiation therapy, and prostate-specific antigen level decreased to undetectable level. Biochemical failure after transperineal brachytherapy for prostate cancer should be considered as a perineal recurrence.
keywords:

prostate cancer, ductal adenocarcinoma, brachytherapy, perineal recurrence, neoplasm seeding

  
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