Objectives: PSA is regarded as the best method in the follow-up of prostate carcinoma. After radical vesiculo-prostatectomy the prostate carcinoma seldom recurs at zero or nearly zero PSA levels.
Methods: The authors have used PSA since 1989 and they have found only one case where metastasis in the tibia came without an increase in PSA levels.
Results: Tibia metastasis showed lower tissue activity of PSA than did the primary tumor in the prostate. The authors think this explains the zero PSA level when the metastasis developed.
Conclusions: The authors think based on their case that PSA free progression prostate cacncers may cases where the metastases do not produce PSA.