Fast Five Quiz: Advanced and Metastatic Prostate Cancer Presentation and Diagnosis

Daniel S. Schwartz, MD, MBA

Disclosures

June 27, 2022

Squamous cell carcinoma of the prostate may be observed in men who are treated with hormonal therapy. Similarly, transitional cell carcinoma and sarcoma of the prostate can occur in men who have undergone previous pelvic radiotherapy for prostate cancer. These can all appear as a large pelvic mass with or without metastases.

The measurement of bound and free PSA levels aids in distinguishing a mildly elevated PSA level caused by cancer from an elevated level caused by benign prostatic hyperplasia. The lower the free-to-total PSA ratio, the higher the likelihood of cancer.

Bony metastases can mimic Paget disease of the bone in radiologic findings. Additionally, although bony metastases are blastic in nature, lytic lesions can occur and cause pathologic fractures.

Learn more about the differential diagnosis of advanced prostate cancer.

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