Onkológia S1/2026
Long-term control of metastatic hormone-sensitive prostate cancer with multiple liver metastases
Aim: The aim of this case report is to present a case report of a patient with de novo metastatic prostate cancer with multiple liver metastases in whom long-term disease control was achieved using combination therapy.
Case description: We present the case of a 65-year-old patient with histologically confirmed prostate adenocarcinoma with neuroendocrine differentiation, Gleason score 8 (4+4). The initial PSA level was 80 ng/mL. Staging CT revealed multiple focal liver lesions, which were initially interpreted as benign in the context of the patient’s history of Q fever. After completion of radiotherapy and ADT, the patient showed a significant increase in PSA levels. Additional imaging with 68Ga-PSMA-PET/CT and liver MRI demonstrated multiple hepatic lesions. Liver biopsy confirmed metastases of conventional prostate adenocarcinoma. The patient underwent seven cycles of docetaxel chemotherapy, which was discontinued due to cardiac toxicity. Subsequently, treatment with the ARPI enzalutamide was initiated. The patient has been benefiting from therapy for four years with no observed adverse effects related to enzalutamide.
Conclusion: This case highlights the importance of a comprehensive diagnostic approach, including histological verification of unclear visceral lesions, 68Ga-PSMA-PET/CT imaging, as well as the benefit of intensified systemic therapy. The combination of ADT, radiotherapy, docetaxel chemotherapy, and subsequent treatment with enzalutamide may lead to long-term disease control even in patients with high-risk mHSPC with liver metastases.
Keywords: metastatic hormone-sensitive prostate cancer, liver metastases, treatment, enzalutamide
