Undetectable prostate specific antigen in disseminated prostate cancer

Since 1984 prostate specific antigen (PSA) has been used for screening, diagnosis and followup of prostate cancer. Although this tissue marker is specific for organ and not for disease, many studies have confirmed its high ranking as a marker for prostate cancer, especially for followup after radical prostatectomy. At the time of PSA recurrence, tumor recurrence can be local and/or distant. We report our first case of distant tumor recurrence after radical prostatectomy without PSA recurrence.