Abstract
High-intensity focused ultrasound (HIFU) is a focal therapeutic approach for localised non-metastatic prostate cancer. We report a 53-year-old man who failed active surveillance of prostatic adenocarcinoma in the right lobe and underwent HIFU focal therapy. He experienced an outfield recurrence in the contralateral lobe thereafter and underwent salvage radical prostatectomy. We discuss the histopathological features in the salvage radical prostatectomy post HIFU treatment, its relationship to the outfield recurrence and the management.