Robotic‐assisted laparoscopic radical prostatectomy for treatment of a newly identified lesion revealed no viable cells in the previously treated area with microwave focal therapy

Abstract

Introduction Histological outcome of the targeted focal therapy is in principle confirmed by targeted needle biopsy from the treated area in clinical trial. Herein, we report a rare case in which the MFT was followed by RARP. Case presentation A 68‐year‐old man with PSA 9.6 ng/mL and PI‐RADS 4 lesion in the right transition zone on multi‐parametric MRI underwent MR/ultrasound fusion‐guided targeted biopsy, which revealed grade‐group 1 cancer. Targeted focal therapy with microwave ablation was performed, resulting in disappearance of the PI‐RADS 4 lesion at post‐operative 4 months. However, PSA rose to 11.5 ng/mL, and a new PI‐RADS 4 lesion, was identified in the left peripheral zone. RARP was performed to reveal new grade‐group 3 cancer, and no viable cells in the previously treated area with MFT. Conclusion RARP was safely performed even after MFT and proved the pathological complete response of microwave ablation.

Keywords

• microwave focal therapy
• mpMRI
• MR/US fusion‐guided targeted biopsy
• prostate cancer
• RARP