Advanced prostate cancer with extremely low prostate-specific antigen value at diagnosis: an example of high dose hook effect.
A 67-year-old man presented with a lower abdominal mass. Radiographic examination revealed a huge mass filling the entire pelvis. Although prostate-specific antigen (PSA) was 1.4 ng/ml, percutaneous needle biopsy revealed adenocarcinoma compatible with prostate cancer, which stained positive for PSA. Hormone therapy was initiated and 1 month later his PSA was as high as 2713 ng/ml, although the mass had decreased in size. High dose hook effect was suspected and hormone therapy was continued. PSA is presently under control and below 0.1 ng/ml. When prostate cancer with very high PSA is suspected and the PSA value is unexpectedly low hook effect should be considered and PSA should be re-analyzed.
Akamatsu
Shusuke
S
Department of Urology, Shizuoka General Hospital, Japan. ant110@hotmail.com
Tsukazaki
Hideki
H
Inoue
Kouji
K
Nishio
Yasunori
Y
D000230:Adenocarcinoma / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D000368:Aged; D001707:Biopsy, Needle; D003937:Diagnosis, Differential; D004305:Dose-Response Relationship, Drug; D005500:Follow-Up Studies; D007987:Gonadotropin-Releasing Hormone / Q000008:administration & dosage* / Q000031:analogs & derivatives*; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D017430:Prostate-Specific Antigen / Q000378:metabolism*; D011471:Prostatic Neoplasms / Q000175:diagnosis / Q000188:drug therapy / Q000378:metabolism; D012720:Severity of Illness Index; D014057:Tomography, X-Ray Computed
D007987:Gonadotropin-Releasing Hormone; D017430:Prostate-Specific Antigen