Fig. 2

Primary and metastatic lesions during the treatment course. a T2WI of MRI showed a prostate tumor invading the right seminal vesicle at the primary diagnosis. b MRI showed that the primary lesion had shrunk after androgen deprivation therapy (ADT) and cabazitaxel (CBZ) therapy. The second biopsy revealed total elimination of the variable tumor. c T1WI of MRI with Gd enhancement showed the enlarged right inguinal lymph node, which was biopsied for whole-exome analysis and underwent WGD. d T2WI of lumbar MRI performed after CBZ showed diffuse metastases in L5/S1 vertebrae. The metastatic tumor in L5 was reaching toward the epidural space. e Lumbar MRI performed 2 years later showed the spreading of metastases to L4 vertebrae and spinal cord compression at the level of L4/L5, causing leg paralysis