At initial presentation, review of slides and blocks of prostatic core biopsies (done in another hospital) showed prostatic adenocarcinoma in all core biopsies. Gleason grade = 7a (3 + 4). Perineural invasion: identified in core biopsy of right mid prostate. Lymphovascular space invasion: not identified.

Baseline PSA level was 11 ug/L (reference range ≤4 ug/L) which increased progressively during the follow up and after two years, the PSA level was 640 ug/L.

Follow up radiographs and bone scan showed progressive bone disease.