Management of a localized prostatic adenocarcinoma despite the very high rate of PSA and the large tumor mass: Does PSA level indicate the stage of prostate cancer?

Prostate-specific antigen (PSA) is a marker specific to the prostate gland, and it is, therefore, possible to observe an increase in PSA above 4 ng/mL in cases of benign prostatic hypertrophy and cancer. But according to studies, a very high PSA level is most likely synonymous with metastatic prostate cancer. Our rare case concerns the management of a localized prostatic adenocarcinoma despite a very high PSA level of over 3000 ng/mL, with an enormous volume of prostate without invasion or distant metastasis. A very high PSA level can probably be a sign of metastatic prostatic adenocarcinoma, but not necessarily.