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editorial
. 2020 Nov 8;46(1):49–51. doi: 10.1097/RLU.0000000000003400

FIGURE 2.

FIGURE 2

Four years later, the patient was diagnosed as a castrate-resistant state (PSA 2.14 ng/mL); the contrast-enhanced CT (A) revealed a mass at the descending portion of the duodenum. Three months after treatment with enzalutamide, the mass increased in size against PSA decrease (PSA 0.21 ng/mL) (B). (Arrowheads in A and B indicate the duodenal tumor.) T5 metastasis showed no significant change in bone scintigraphy after the enzalutamide treatment (C, D). On the other hand, the continued growth of duodenal tumor caused bile duct obstruction (not shown). Because metastasis of prostate cancer to small intestine is very rare, primary cancer or another kind of tumor was suspected but not diagnosed definitely.5–9 It was necessary to exclude the metastasis of prostate cancer for the treatment policy decision.