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Introduction: Prostate cancer is the sixth most common cancer in the world, the second most common cancer among men, and the most common cancer in men in Europe. Metastatic prostate cancer among young patients represents the rarest of the newly diagnosed prostate cancer, with few reports of cases with a longer survival. Case presentation: We present the case of a 59 year-old male who was referred with back pain over the last month. Digital rectal examination highlighted an enlarged and totally indurated prostate of 4x4.5 cm, while abdominopelvic X-rays showed osteoblastic metastases in the spine and pelvis bones. Laboratory examinations revealed a Prostate Specific Antigen level of 7941 ng/ml. Prostate biopsy histology showed a bilateral prostate cancer with a Gleason score of 8. Androgen deprivation therapy and daily administration of biphosphonates were prescribed. After two years of treatment, the Prostate Specific Antigen level decreases to 8 ng/ml. Conclusions: We reported the highest Prostate Specific Antigen level in a patient under 60 years old with metastatic prostate cancer. Prostate cancer remains an important public health problem due to the aggressiveness of the disease and advanced stage upon diagnosis. Prostate Specific Antigen is mandatory to evaluate, to have a reference level in order to prevent metastatic prostate cancer in young patients at diagnosis. IntroductionProstate cancer (PCa) is the sixth most common cancer in the world, the second most common cancer among men, and the most common cancer in men in Europe, North America, and parts of Africa [1]. In 2000, there were 513,000 newly diagnosed cases worldwide, while in 2012 there were 1.1 million. This suggests an increased incidence of prostate cancer in the past decade [2].Prostate-specific antigen (PSA) is a protein produced by the epithelial cells of the prostate gland. Its main attribution is to liquefy the semen in the seminal coagulum allowing the sperm to move freely. PSA is present in the serum in small quantities in healthy people, but it has an elevated level in case of prostate cancer or other prostatic disorders.Even if PCa is an important health problem worldwide, screening based on Prostate-Specific Antigen (PSA) determination seems to increase the overall health care costs and early detection of prostate cancer, leading to an earlier treatment with several years before regular occurrence. Decision analysis models have been used to evaluate the effectiveness of prostate cancer screening and treatment, but little or no benefit was found [3].Metastatic Pca (mPCa) among young patients represents few of the newly diagnosed PCa, most of the clinical trials showed a mean survival after diagnosis up to 3 years, with few case reports of longer survival [4]. Very high PSA levels in mPCa at diagnosis are rarely reported and none referring to a Caucasian male under 60 years old [5,6]. Case presentationWe present the case of a 59 year-old Caucasian male patient who was referred to the Urology Emergency Unit of the Mures County Hospital...

Objectives. The purpose of this study was to determine the evolution of patients with unifocal lateral wall MIBC (muscle invasive bladder cancer) after cystectomy with PLND (pelvic lymph node disection) at the Urology Clinic in Tirgu Mures, and to determine tumor stage and lymph node status before and after radical cystectomy with PLND. Methods. This is a prospective study, conducted between 1 August 2012 to 31 July 2014 at Urology Clinic, with a median follow-up of 14 months (range 7-25). Inclusion criteria were: patients undergone cystectomy with PLND, and unifocal MIBC on the lateral wall of the bladder; exclusion criteria were: multiple bladder tumor, other location and clinical T stage > 3. Results. Forteen patients met the inclusion criteria, median age was 61 (range 55-72), 85.71 % were male. An increase in T3 patients was noticed from 1 to 5 cases, we noticed a decrease of N0 lymph nodes from 78.6% to 57.1% postoperatively and on the controlateral side the kappa coefficient between the preoperatively and postoperatively negative lymph nodes was 0.63. On the tumor side the most common location for positive lymph nodes was external iliac with 3 nodes (21.4 %) and obturator fossa with 4 nodes (28.6 %) and on the contralateral side 2 positive nodes (14.3 %, obturator fossa, external, internal and common iliac nodes). Conclusions. In unifocal bladder tumors, located on the lateral wall, PLND could be an alternative with comparable results with extended PLND especially in T1 and T2 patients associated with N0 before and after surgery.