How do you approach a patient with prostate cancer with sclerotic/lytic lesions found on a CT scan but not seen on a bone scan or PET-PSMA?

Topics: Radiation Oncology • Genitourinary Cancers • Prostate Cancer • Medical Oncology

How do you approach a patient with prostate cancer with sclerotic/lytic lesions found on a CT scan but not seen on a bone scan or PET-PSMA?

Would you consider these as metastatic sites? Would you biopsy to confirm?

Answer from: Radiation Oncologist at Academic Institution

This can be a tough situation, as sometimes healthy individuals can have sclerotic or lytic foci in various bones for reasons unrelated to any type of malignancy. The first thing I would try to do is compare the CT scans to any prior imaging if possible. If these lesions are completely unchanged fro...

Comments

Radiation Oncologist at Kansas City VA Medical Center
We do come across this kind of clinical situation,...

Answer from: Radiation Oncologist at Community Practice

MRI may be helpful otherwise consider benign.

Answer from: Radiation Oncologist at Community Practice

For this type of situation, one has to look at the overall clinical picture. What is the PSA and/or is it rising? If it's very low, I would be much less suspicious of these lesions and likely would follow with a repeat scan in a few months to assure stability then perhaps another in 6 months to a ye...

Related Questions