A case report of prostate specific membrane antigen positron emission tomography and risk of overtreatment in a man on active surveillance for early-stage prostate cancer

We report the case of a 63 years-old man managed with active surveillance for low-risk prostate cancer for seven years, who underwent radical prostatectomy due to multiple uptakes at prostate specific membrane antigen positron emission tomography ordered due to rising PSA despite three negative surveillance biopsies and three negative multiparametric magnetic resonance imaging scans. The final pathology specimen showed organ confined, low volume grade group 1 disease (Gleason 3+3), without lymph node involvement and with clean surgical margins. The patient has been biochemical recurrence free for three years post prostatectomy.