An Enhancing Renal Mass in Metastatic Prostate Cancer.

A 59-year-old male with a history of metastatic prostate cancer (mPCa) was seen in clinic. He had been diagnosed 4 years prior and received docetaxel and hormonal therapy. Response to systemic treatment was excellent and he underwent radical prostatectomy with lymph node dissection as part of a clinical trial. Final pathology was ypT3bN1 with left seminal vesicle invasion and negative margins. His PSA was undetectable postoperatively and he received adjuvant pelvic radiation. Cross-sectional imaging after radiation was negative for residual metastatic disease. His PSA remained undetectable for 3 years until it rose to 0.6 ng/mL. A PSMA PET showed mild avidity in subcentimeter periaortic nodes and a right renal mass demonstrating enhancement on MRI (Fig. 1).