A 70-year-old Caucasian male with monoclonal gammopathy of undetermined significance (MGUS) and high risk adenocarcinoma of the prostate (T3b, Gleason score: 3 + 4 = 7, prebiopsy PSA: 74.3 ng/mL) who completed external beam radiation therapy to the prostate, periprostatic lymphatics, seminal vesicles, and regional pelvic lymphatics concurrent with ADT (leuprolide 22.5 mg IM every 3 months) was found to have evidence of sclerotic and blastic bony lesions, suspicious for metastatic prostatic cancer, 6 months following primary therapy with restaging imaging (Figure 3). The gene discussed is KLK3; the disease is prostate adenocarcinoma.