Return of serum prostate specific antigen to undetectable level following removal of solitary lymph node metastasis

Historically pelvic lymph node metastasis of prostate cancer has been considered a systemic disease that is incurable by regional therapy, including surgery and radiation. We report a case in which an isolated pelvic lymph node recurrence was removed during low anterior resection of the rectum. The patient had previously undergone radical retropubic prostatectomy and bilateral pelvic lymphadenectomy for adenocarcinoma of the prostate. Serum prostate specific antigen (PSA), which had become detectable 1 year after radical retropubic prostatectomy, returned to an undetectable level following low anterior resection of the rectum. PSA remained undetectable for 18 months postoperatively.