A challenging diagnosis of prostate cancer seeding in the perineal needle-tract after transperineal biopsy: is PET-CT the imaging of choice?

Claudia Fede Spicchiale; Federico De Leonardis; Luca Orecchia; Stefano Germani; Anastasios D Asimakopoulos; Roberto Miano

doi:10.1016/j.eucr.2024.102852

A challenging diagnosis of prostate cancer seeding in the perineal needle-tract after transperineal biopsy: is PET-CT the imaging of choice?

Urol Case Rep. 2024 Sep 25:57:102852. doi: 10.1016/j.eucr.2024.102852. eCollection 2024 Nov.

Authors

Claudia Fede Spicchiale¹, Federico De Leonardis¹, Luca Orecchia¹, Stefano Germani¹, Anastasios D Asimakopoulos¹, Roberto Miano²

Affiliations

¹ Urology Unit, AOU Policlinico Tor Vergata, Rome, Italy.
² Department of Surgical Sciences, Urology Unit, University of Rome Tor Vergata, AOU Policlinico Tor Vergata, Rome, Italy.

Abstract

Perineal seeding is an extremely rare complication after prostate biopsy. We found a perineal localization of prostatic adenocarcinoma 5 years after the transperineal biopsy in a patient with metastatic castration resistant prostate cancer. The tumor was identified by a¹⁸F-Fluorocholin positron emission tomography-computed tomography (¹⁸F-FCH PET-CT) performed after a sudden rise of PSA levels during androgen deprivation therapy and after a negative CT scan. This case report underscores the challenge one may encounter in detecting perineal prostate cancer metastasis after a biopsy when using traditional imaging with CT scan alone or MRI, and the added diagnostic value of PET-CT imaging.

Keywords: Cancer seeding; Positron emission tomography-computed tomography (PET-CT); Prostate cancer; Transperineal biopsy.

Publication types

Case Reports