A case of rapidly progressive prostate cancer with bone and lymph node metastasis after contact laser vaporization for benign prostatic hyperplasia

Introduction: Prostate cancer is incidentally diagnosed in 6%-11% of benign prostatic hyperplasia surgeries.

Case presentation: A 79-year-old man was diagnosed with benign prostatic hyperplasia. The prostate volume was 54.5 mL, and the prostate-specific antigen level was 7.121 ng/mL. Magnetic resonance imaging and prostate biopsy were not performed. He then underwent contact laser vaporization of the prostate. After 3 months, gross hematuria occurred, and the prostate-specific antigen level was 62.495 ng/mL. Cystoscopy and magnetic resonance imaging revealed prostate cancer with bladder invasion. Prostate biopsy and transurethral resection were performed, revealing adenocarcinoma with a Gleason score of 5 + 5. The patient was diagnosed with prostate cancer T4N1M1b, and triplet therapy was initiated. After 6 months, the prostate-specific antigen level was 0.037 ng/mL, and the metastases had shrunk.

Conclusion: Vaporization for high-grade prostate cancer can lead to rapid progression. Therefore, screening for prostate cancer before benign prostatic hyperplasia surgery is important.