Leptomeningeal metastasis from prostate cancer (original) (raw)
Related papers
A case report of prostate cancer with leptomeningeal metastasis
Cancer Reports
Background: Prostate cancer is the most prevalent cancer in men. However, leptomeningeal involvement by prostate carcinoma is a rare event. Case: Here, we report a 69-year-old patient with castration-resistant metastatic prostate cancer who presented with headache and ataxia. Brain MRI revealed a huge invasive interaxial mass at right occipital lobe with diffuse thickening and enhancement of meninges, the arachnoid, and the pia mater, and he was diagnosed with leptomeningeal carcinomatosis. The patient received whole brain radiotherapy. Conclusion: Despite the fact that brain and leptomeningeal metastases are not very common in patients with prostate cancer, signs and symptoms of nervous system disorders should be assessed carefully, and consideration of such unusual metastases must be considered.
Clinical Case Reports, 2021
Despite the prostate cancer is the most prevalent men cancer, metastases to the central nervous system including leptomeningeal involvement by prostate carcinoma are a rare event. Here, we detected leptomeningeal carcinomatosis based on MRI findings in a 67-year-old patient with castration-resistant metastatic prostate cancer who presented paraplegia and paresthesia of both limbs. Prostate cancer is second only to lung cancer as a leading cause of cancer-related death in men. 1 Most men with prostate cancer have asymptomatic and indolent disease. In advanced stages, the most common locations of metastasis from the prostate are bone, lung, and liver. 2 Central
Surgical neurology, 2006
Background: Leptomeningeal metastasis is discovered at autopsy in approximately 5% of patients with systemic cancer. Until recently with the introduction of magnetic resonance imaging (MRI), premorbid diagnosis was extremely difficult. In particular, initial spinal fluid cytology is diagnostic in less than 50% of autopsy-verified patients, although repeated spinal fluid examinations may increase the yield significantly. Leptomeningeal metastasis in metastatic prostate cancer has been reported in only 14 patients previously. Case Description: We recently studied such a patient and were able to establish a correct diagnosis based solely on the MRI and the presence of an elevated cerebrospinal fluid (CSF) prostate-specific antigen (PSA). Only 3 previous patients with leptomeningeal prostate metastasis have undergone CSF PSA evaluations. Conclusion: We believe that, in such patients, the combination of MRI and CSF studies can overcome the lack of sensitivity of CSF cytology.
Brain metastasis from prostate carcinoma
Cancer, 1999
BACKGROUND. In patients with prostate carcinoma, brain metastasis has most commonly been reported in autopsy series. Symptomatic brain metastasis from prostate carcinoma has occasionally been detected.
Journal of Medical Imaging and Radiation Oncology, 2008
Metastases from prostate cancer occur largely in bone through a haematogenous route. Metastatic spread of prostate cancer to the leptomeninges was rarely seen in the past. However, there has been a recent increase in presentations of leptomeningeal spread from prostate cancer in our institutions. Between 2004 and 2006, four patients were diagnosed with metastatic prostate cancer with leptomeningeal metastases in our centres. All four patients had hormone refractory prostate cancer and had previously had chemotherapy. The median survival of these patients was approximately 15 months from the time of hormone refractoriness. The prognosis of leptomeningeal metastasis secondary to metastatic prostate cancer is poor, ranging from 2 to 7 months as seen in our series. New cases of leptomeningeal metastases seen in our series are hypothesized to be secondary to the use of effective modern systemic treatments. A parallel might be drawn with the increased rate of central nervous system metastases in breast cancer since the introduction of effective cytotoxic treatments and more recently targeted therapies. We suggest the clinicians to be aware of the potential change of natural history and pattern of progression in metastatic prostate cancer.
Brain Metastasis From Prostate Adenocarcinoma: Case Report and Review of Literature
World Journal of Oncology, 2012
It is rare for prostate carcinoma to metastasize to the central nervous system. It often represents a terminal event with death in one year frequently due to the advanced systemic disease. Starting by a case report, we also reviewed the relevant literature to focus on this uncommon entity from epidemiology to clinical manifestation and therapeutic strategies. In this article, a case of multiple brain prostate metastasis is reported and a review of relevant literature is also discussed. Treatments available for intracranial metastasis include neurosurgery, external beam radiation and hormonal manipulation. Surgery associated with whole brain radiotherapy seems to be effective in the control of brain lesions both relieving neurological symptoms and prolonging survival, even if prognosis remains dismal. From this case, we concluded that brain metastasis from prostate carcinoma is a rare, terminal event with death in one year frequently due to the advanced systemic disease. A better understanding of the biology of prostate carcinoma will help clarify the basis for its metastasis to the brain.
Brain metastasis from prostate carcinoma: Antemortem recognition and outcome after treatment
Cancer, 1999
Brain Metastasis from Prostate Carcinoma Antemortem Recognition and Outcome after Treatment W e read with interest the article on brain metastasis from prostate carcinoma (CaP) by McCutcheon et al. 1 published in Cancer. For the benefit of the readers, we would like to update and refine the data regarding solitary brain metastasis from CaP. Using the MEDLINE database, we reviewed the data concerning brain metastasis and prostate carcinoma in living patients from 1960 to 1999. We excluded patients who lacked a negative metastatic survey and a brain biopsy consistent with CaP. We found a total of eight patients who met our criteria. Sites of single metastasis included pons alone (one patient), pons at the cerebellar-pontine angle (one patient), pons and cerebral peduncle (one patient), pons and cerebellar peduncle (one patient), pons and midbrain (one patient), the parietal lobe (one patient), the temporal lobe (one patient), and the frontoparietal lobe (one patient). Brain biopsy yielded seven patients with CaP and one patient with papillary adenocarcinoma. Brain histology included poorly differentiated (two patients), moderately differentiated (one patient), and well differentiated (four patients) CaP. The rate of incidence of brain metastasis from CaP in the recent study by McCutcheon et al. was 0.7%. 1 One study proposes four reasons for the low incidence rate of clinically suspect solitary brain metastasis from CaP: 1) lower detection rate of tumor spread to brain (even in autopsy data), 2) late occurrence of brain involvement in the course of the disease, 3) clinically silent growth related to the most common site of tumor involvement, and 4) rare and nonspecific symptoms due to brain metastasis from CaP. 2,3 Another hypothesis for the rarity of solitary brain metastases in patients with CaP is that the brain parenchyma does not represent "fertile soil" for CaP cells, just as, conversely, the skeleton provides a preferential milieu for these cells. 4 We believe our review shows the highest percentage of prostate metastasis to the pons Ϯ cerebrum, cerebellum, and midbrain reported to date. McCutcheon et al.'s large series included only three patients who had metastatic disease solely to the brain. One patient had metastases specifically to the hypothalamus and the right temporal lobe. The other two patients had multiple frontal metastases. Their review also included seven additional patients who presented with a solitary brain metastasis. To our knowledge the study by Gupta et al. was the only analysis that met the criteria for our study. 5 The number of solitary brain metastasis from CaP may indeed be higher than previously thought. McCutcheon et al. were correct to speculate that given the obscuring effect of bone artifact in the posterior fossa on computed tomography (CT) scans of the brain, tumor in this location actually may be underreported when CT is the primary method used. The fact that magnetic resonance imaging diagnosed all the patients with a solitary brain metastasis to the pons lends support to their theory.
Neurologic Clinics, 2003
Metastases to the nervous system are an increasingly common complication of cancer, and can involve the brain parenchyma, dura, skull, epidural space, peripheral nerves, and leptomeninges (pia and arachnoid membranes). Leptomeningeal metastasis (LM) is defined as the appearance of tumor cells in the leptomeninges or cerebrospinal fluid (CSF) distant from the site of a primary tumor [1]. LM is also know as carcinomatous meningitis, neoplastic meningitis, neoplastic meningosis, leukemic meningitis (for leukemia), lymphomatous meningitis (for lymphoma), and meningeal carcinomatosis (for carcinoma) [2-11]. LM was first described in 1870 in a patient with lung cancer, and was thought to be a rare condition, usually diagnosed at autopsy [12]. By the 1970s, the condition was increasingly diagnosed due to increased suspicion and improved diagnostic tests [8,13]. As treatments for systemic cancers improve and as patients live longer, there is a higher risk of central nervous system (CNS) metastases, including LM. LM has a devastating impact on the prognosis and quality of life for affected patients. Neurologic dysfunction may severely impair the ability of a patient to function independently. Advances in diagnostics, chemotherapy, radiotherapy, and surgery have made it possible to partially alleviate symptoms and to improve the quality of life. Further advances in modalities that may allow earlier diagnosis of LM and the development of more effective therapeutics may offer future patients with LM an improved quality of life and longer duration of survival.
2021
Prostate cancer is the most common cancer and among the leading causes of cancer death in men and its clinical symptoms vary a lot. The most common metastatic site is the bones, but rarely prostate cancer can metastasize to brain in very advanced stages of the disease. However, brain metastases giving neurological symptoms as first manifestation of prostate cancers have been reported. Research of international literature revealed only seventeen patients (including our own) that were diagnosed with prostate cancer presented with neurological symptoms.
Prostate Cancer
Aim. Prostate cancer (PCa) is the second most common nonskin malignancy and the second most common cause of cancer-related deaths in men. The most common site of metastasis in PCa is the axial skeleton which may lead to back pain or pathological fractures. Hematogenous spread to the brain and involvement of the central nervous system (CNS) are a rare occurrence. However, failed androgen deprivation therapy (ADT) may facilitate such a spread resulting in an advanced metastatic stage of PCa, which carries a poor prognosis. Methods. In this systematic review, we searched the PubMed, Scopus, and Web of Science online databases based on the PRISMA guideline and used all the medical subject headings (MeSH) in terms of the following search line: (“Brain Neoplasms” OR “Central Nervous System Neoplasms”) and (“Prostatic Neoplasms” OR “Prostate”). Related studies were identified and reviewed. Results. A total of 59 eligible studies (902 patients) were included in this systematic review. In or...