The possibility and possible aetiology of local prostate cancer (PC) recurrence despite undetectable prostate-specific antigen (PSA) levels are highlighted. A case of a local recurrence 8.5 years after radical prostatectomy for Gleason 3+4 PC is presented. It demonstrates that PC can recur, even after a prolonged period of time (8.5 years), despite undetectable levels (i.e. <0.02ng/ml) of PSA. In conclusion, the decision to omit digital rectal examination from the follow-up regimens of men with undetectable PSA levels could be justified. In such exceptional cases, however, PC recurrence would be either missed or would only be diagnosed after a considerable delay.

Local neoplasm recurrence, Prostate-specific antigen, Prostatic neoplasm, Radical prostatectomy,
Prostate Cancer and Prostatic Diseases
Department of Pathology

Roemeling, S, Leenders, G.J.H.L, & Schröder, F.H. (2006). Very late local recurrence after surgery for prostate cancer unaccompanied by detectable PSA levels. Prostate Cancer and Prostatic Diseases, 9(2), 192–194. doi:10.1038/sj.pcan.4500861