Spontaneous remission of a bony metastasis in prostatic adenocarcinoma.

CASE REPORT A 59-year-old man originally presented with T3 pT3NlMO grade 2 prostatic adenocarcinoma after radical retmpubic prostatectomy. After 9 years he underwent surgical castration for a painful solitary metastatic lesion in the right pelvis, confirmed by highly elevated prostatic acid phosphatase and prostate specific antigen (PSA), and a new metastasis seen on a bone scan of the right 0s ischium. Palliative irradiation was given 2 years later due to increasing pain and confirmed histological evidence of metastatic prostatic adencarcinoma tissue by bone biopsy (fig. 1). (The Tandem-E PSA assay was used before January 1993 and the Abbott IMx assay was used thereafter.) PSA increased dramatically 1 year later without clinical signs of local recurrence or new metastatic lesions. Subsequently PSA suddenly and unexpectedly decreased (fig. 2). Presently PSA has been stable at 0.4 MA. (normal 0 to 4) for 12 months and the metastasis seen on the bone scan has completely disap peared. 140