Multimodal Management of Advanced Metastatic Prostate Cancer: Excellent Response Following Resection of Brain Metastasis and 177Lu-PSMA Therapy.

A 68-year-old man with metastatic prostate adenocarcinoma was treated with androgen-deprivation therapy and chemotherapy. Restaging 68Ga-PSMA PET/CT revealed a PSMA-avid lesion in the left temporal lobe, which was treated with brain radiotherapy. Subsequent PSMA PET/CT showed brain lesion progression and skeletal metastases. He underwent brain lesion resection followed by 4 cycles of 177Lu-PSMA-617, achieving near-complete resolution of skeletal metastasis. This case highlights the importance of multimodal treatment, including 177Lu-PSMA, in managing brain metastasis in prostate cancer.