{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T16:10:52Z","timestamp":1779207052975,"version":"3.51.4"},"reference-count":32,"publisher":"MDPI AG","issue":"10","license":[{"start":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T00:00:00Z","timestamp":1779148800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Prostate Action, Inc."}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background\/Objectives: Metastatic Prostate Cancer (mPCa) is generally treated with systemic therapy. Many of these treatments, particularly androgen ablation, are not curative and cause substantial morbidity. Oligometastasis is defined as a limited number of metastatic deposits, whose disease does not seem to progress to a widespread distribution of cancer. There have been some reports of trials of localized treatment of PCa oligometastatic disease with curative intent. We herein report a case of oligometastatic prostate cancer treated primarily with surgical removal of metastases, which has no evidence of active disease twenty years post-operatively. Methods: Extensive retrospective chart review, immunohistochemical staining, growth rate calculations, and imaging studies were performed to trace the progression of this patient\u2019s disease course. Results: A detailed investigation of biochemical markers of recurrence revealed normal-low prostate specific antigen (PSA) despite advanced disease, early rather than metachronous dissemination of metastases to distant sites, and hypoxia-conditioned phenotypic plasticity and memory in disseminated tumor cells (DTCs). Conclusions: This rare outlier case of oligometastatic prostate adenocarcinoma challenges traditional linear models of metastatic progression and clinical reliance on PSA as a marker for PCa detection and treatment in advanced cases. By investigating key questions regarding the identity, timing, and trajectory of DTCs, we propose a biologically informed narrative of this patient\u2019s disease progression and a reconsideration of metastases directed therapy (MDT) of oligometastases as primary therapy in select patients.<\/jats:p>","DOI":"10.3390\/jcm15103910","type":"journal-article","created":{"date-parts":[[2026,5,19]],"date-time":"2026-05-19T15:17:23Z","timestamp":1779203843000},"page":"3910","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Oligometastatic Prostate Cancer: Clues from an N-of-1"],"prefix":"10.3390","volume":"15","author":[{"given":"Alexander","family":"Kirschenbaum","sequence":"first","affiliation":[{"name":"Department of Urology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0005-0049-4594","authenticated-orcid":false,"given":"Parisa","family":"Verma","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pamela","family":"Cheung","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Shen","family":"Yao","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Drummond","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Isabella","family":"Tipi","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andy","family":"Yao","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0634-4133","authenticated-orcid":false,"given":"Alice C.","family":"Levine","sequence":"additional","affiliation":[{"name":"Division of Endocrinology, Diabetes and Bone Diseases, Department of Medicine, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"},{"name":"Department of Oncological Sciences, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,5,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1683","DOI":"10.1016\/S0140-6736(24)00651-2","article-title":"The Commission on prostate cancer: Planning for the surge in cases","volume":"403","author":"James","year":"2024","journal-title":"Lancet"},{"key":"ref_2","first-page":"10","article-title":"Cancer statistics, 2025","volume":"75","author":"Siegel","year":"2025","journal-title":"CA Cancer J. 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