International Cancer Conference Journal

, Volume 7, Issue 3, pp 81–83 | Cite as

A case of rapidly progressing prostate cancer diagnosed 20 months after holmium laser enucleation of the prostate

  • Kazutaka Kida
  • Yousuke Shimizu
  • Kosuke Ogawa
  • Masahiro Emura
  • Sojun Kanamaru
  • Noriyuki Ito
Case report


A 65-year-old man presented for treatment of benign prostatic hyperplasia. His prostate volume was 50 cm3 and serum prostate-specific antigen was 1.93 ng/mL. Digital rectal examination showed no malignant nodules on the surface of the prostate. Holmium laser enucleation of the prostate was performed. The enucleated tissue was 21 g and pathological examination revealed no malignancy. Serum prostate-specific antigen had increased continuously to 6.38 ng/mL and prostate biopsy was performed 20 months after holmium laser enucleation of the prostate. Pathological examination confirmed an adenocarcinoma of the prostate with a Gleason score of 9 (4 + 5). Computed tomography and bone scintigraphy demonstrated multiple bone metastases and we made a diagnosis of prostate cancer, cT2aN0M1b. After 3 months on androgen deprivation therapy, he developed castration-resistant prostate cancer and died within 13 months after diagnosis of prostate cancer, despite receiving sequential therapy including enzalutamide, docetaxel and abiraterone. In our case, prostate-specific antigen was not measured until 13 months after holmium laser enucleation of the prostate, after which prostate-specific antigen rose from 1.93 to 4.09 ng/mL. This report provides an important implication of continuous monitoring of prostate-specific antigen after holmium laser enucleation of the prostate to detect prostate cancer early.


Prostate cancer Holmium laser enucleation of the prostate 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Informed consent

The patient provided a written informed consent for his case report to be published anonymously.


  1. 1.
    Nunez R, Hurd KJ, Noble BN et al (2011) Incidental prostate cancer revisited: early outcomes after Holmium laser enucleation of the prostate. Int J Urol 18:543–547CrossRefPubMedGoogle Scholar
  2. 2.
    Rivera ME, Frank I, Viers BR et al (2014) Holmium laser enucleation of the prostate and perioperative diagnosis of prostate cancer: an outcomes analysis. J Endourol 28:699–703CrossRefPubMedGoogle Scholar
  3. 3.
    Bhojani N, Boris RS, Monn F et al (2015) Coexisting prostate cancer found at the time of Holmium laser enucleation of the prostate for benign prostatic hyperplasia: predicting its presence and grade in analyzed tissue. J Endourol 29:41–46CrossRefPubMedGoogle Scholar
  4. 4.
    Hanks GE, Leibel S, Kramer S (1983) The dissemination of cancer by transurethral resection of locally advanced prostate cancer. J Urol 129:309–311CrossRefPubMedGoogle Scholar
  5. 5.
    Babaian RJ, Archer JS (1988) Dissemination of disease following transurethral resection for locally advanced prostate cancer. Urology 31:30–33CrossRefPubMedGoogle Scholar
  6. 6.
    Koguchi D, Nishi M, Satoh T et al (2014) Bone dissemination of prostate cancer after holmium laser enucleation of the prostate: a case report and a review of the literature. Int J Urol 21:215–217CrossRefPubMedGoogle Scholar
  7. 7.
    Mahal BA, Yang DD, Wang NQ et al. (2018) Clinical and genomic characterization of low-prostate-specific antigen, high-grade prostate cancer. Eur Urol. PubMedGoogle Scholar
  8. 8.
    Elmansy HM, Elzayat EA, Elhilali MM et al (2009) Prostatic-specific antigen velocity after holmium laser enucleation of the prostate: possible predictor for the assessment of treatment effect durability for benign prostatic hyperplasia and detection of malignancy. Urology 74:1105–1110CrossRefPubMedGoogle Scholar

Copyright information

© The Japan Society of Clinical Oncology 2018

Authors and Affiliations

  1. 1.Department of UrologyKobe City Nishi-Kobe Medical CenterKobeJapan

Personalised recommendations