Two Cases of Low Prostate-Specific Antigen Localized Prostate Cancer Incidentally Detected by Computed Tomography

The document discusses two cases of localized prostate cancer with low prostate-specific antigen (PSA) levels, detected incidentally through computed tomography (CT) scans. Despite the recommended PSA cut-off for prostate cancer screening being 4ng/ml, these patients had PSA levels below 3ng/ml. The patients, a 61-year-old man with a PSA of 2.54 ng/mL and a 71-year-old man with a PSA of 2.97 ng/mL, both had adenocarcinoma with a Gleason score of 9. The first patient underwent surgery and showed no signs of recurrence or metastasis two years later, while the second patient received maximal androgen blockade with external beam radiation therapy due to his health status. The document concludes that high-grade tumors can present as low serum PSA prostate cancer, and with advanced imaging techniques, such cases are being diagnosed more frequently.