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Paradoxical Early Increase in Prostate-Specific Membrane Antigen Uptake Following Cryoablation for Local Recurrence After Radical Prostatectomy

Mariotti, Guilherme Cayres, MD, MSc*; Cunha, Marcelo Livorsi, MD; Carneiro, Arie, MD, PhD; Smaletz, Oren, MD§; Baroni, Ronaldo Hueb, MD, PhD; Garcia, Rodrigo Gobbo, MD, PhD*

doi: 10.1097/RLU.0000000000002604
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We report a case of a 43-year-old man who underwent a radical prostatectomy 3 years before the procedure (June 2015) for a locally advanced Gleason 7(4 + 3) prostate adenocarcinoma (pT3aN0), with negative surgical margins, followed by salvage radiotherapy. He also underwent antiandrogen therapy for biochemical relapse (bicalutamide) from October 2016 through May 2017, but prostate-specific antigen continued to rise (2.5 ng/mL [December 2017] and 3.3 ng/mL [February 2018]). At this point, he underwent a 68Ga–prostate-specific membrane antigen PET/CT, and after multidisciplinary discussion, the therapeutic option chosen was image-guided salvage cryoablation.

From the Departments of *Interventional Radiology,

Nuclear Medicine,


§Oncology, and

Radiology, Hospital Israelita Albert Einstein, São Paulo, Brazil.

Received for publication December 13, 2018; revision accepted March 21, 2019.

Conflicts of interest and sources of funding: none declared.

Correspondence to: Guilherme Cayres Mariotti, MD, MSc, Av. Albert Einstein, 627 São Paulo, São Paulo 05652-900, Brazil. E-mail:

Online date: May 3, 2019

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