The Diagnostic Approach to Cutaneous Metastases of Adenocarcinoma of the Prostate: A Case Report (original) (raw)
Related papers
Prostate Cancer Cutaneous Metastasis: A Case Report
Urology and Andrology – Open Journal, 2020
Prostate cancer is the second most common cancer in men. It can be located, present local extension and finally metastasize. Cutaneous metastasis is an infrequent event that is associated with a poor prognosis. We present a clinical case of advanced undifferentiated prostate cancer with cutaneous metastases diagnosed by a punch biopsy and confirmed by immunohistochemistry.
Türk Üroloji Dergisi/Turkish Journal of Urology
Prostate cancer is the most common non-cutaneous malignancy and the second cause of cancer death in men. Despite improvements in diagnostic methods, the primary diagnosis of a number of patients may still be on metastatic stage. Cutaneous and supraclavicular lymph nodes are very rare metastatic sites for prostate cancer. In this report we present an extremely rare prostate cancer case diagnosed with supraclavicular lymph node and then developed cutaneous metastasis. A 64 year-old man was admitted to an internal medicine outpatient clinic with supraclavicular lymph node and biopsy of lymph node showed an adenocarcinoma. After prostate cancer diagnosis, patient was treated with androgen deprivation therapy, docetaxel chemotherapy and abiraterone acetate, respectively. While abiraterone treatment, cutaneous metastasis developed in inguinal area and diagnosis was confirmed by skin biopsy. In some cases, atypical symptoms may guide us to find disease with aggressive clinics. That's why, physical rectal examination and prostate specific antigen measurements should be kept in mind for prostate cancer in male patients with supraclavicular lymph node or atypical metastasis.
Cutaneous metastasis of prostate carcinoma treated with radiotherapy: a case presentation
BMC Research Notes, 2014
Background: Prostate cancer is a commonly diagnosed and treated malignancy, although it rarely presents with cutaneous metastases. In this case presentation, we describe the diagnosis and treatment with radiotherapy of a patient who presented with cutaneous metastases on his chest wall secondary to prostate cancer. Case presentation: In 2006, a 73-year-old Caucasian gentleman with metastatic castration resistant prostate cancer treated with mitoxantrone and prednisolone presented with cutaneous nodules on his chest wall. A punch biopsy diagnosed cutaneous metastases, with histological confirmation with positive staining for cytokeratin, PSA (prostate specific antigen) and PAP (prostatic acid phosphatise). Systemic treatment was ceased due to progressive disease; radiotherapy was used to treat these nodules with a durable clinical response. The patient died five months after initial diagnosis of cutaneous metastases. Conclusions: In this report, a rare metastatic manifestation of a common malignancy is presented. Whilst dermal metastases carries a poor prognosis from reported literature, this is the first report of radiotherapy providing a durable clinical response with relief from bleeding and pain.
Small cell carcinoma of the prostate presenting with skin metastasis: a case report
Journal of Medical Case Reports, 2014
Introduction: Small cell carcinoma of the prostate is a very rare and aggressive type of prostatic cancer. Most cases are diagnosed at advanced stage due to early metastasis. The bones, liver, regional and distant lymph nodes are the most common sites of metastasis of small cell carcinoma of the prostate. Skin metastasis of small cell carcinoma of the prostate is a very rare entity due to the uncommon metastatic site. Here, we describe the case of a patient with small cell carcinoma of the prostate which metastasized to his skin. Case presentation: A 74-year-old Caucasian man presented to another urology center for mild lower urinary tract symptoms in 2003. His prostate-specific antigen was 23ng/mL. According to the physical examination signs and prostate-specific antigen, he underwent a transrectal ultrasound-guided prostate biopsy. The pathologic examination of his prostate revealed a Gleason score: 3+4=7 adenocarcinoma of the prostate. Investigations showed stage T2N0M0 disease and he was treated with radiotherapy to his pelvic lymph nodes and prostate. Six years after the initial diagnosis, he complained of a palpable left-side 2×2cm subcutaneous solitary mass localized just behind his scapula. The results of his laboratory tests including serum acid phosphatase and prostate-specific antigen were in normal ranges. Our general surgery department performed a diagnostic biopsy of the mass and totally excised the lesion. The pathologic examination of the mass showed small cell carcinoma metastasis with chromogranin + and the pathologist advised us to examine the lung or prostate for the primary tumor. The patient undertook a transrectal ultrasound-guided prostate biopsy and the pathologic result revealed small cell carcinoma within residual adenocarcinoma. We investigated the other sites for metastasis and restaging investigations showed a 1cm metastatic lesion in his liver. Our medical oncology department decided to treat him with combination chemotherapy with etoposide and cisplatin in six cycles; however, he died due to disseminated myocardial infarction before starting the fifth combination chemotherapy cycle. Conclusions: Clinicians should keep in mind that early diagnosis of this disease is very difficult due to early metastatic spread of small cell carcinoma and lack of concordant elevation of prostate-specific antigen. There is no accepted standard treatment modality for this pathology and overall prognosis is poor.
Recurrence of Prostate Cancer with Cutaneous Metastasis after Radical Prostatectomy
Case Reports in Urology, 2015
While cutaneous metastases are already extremely rare in primary metastatic prostatic adenocarcinoma, cutaneous manifestations in recurrent prostate cancer have rarely been described prior to this report. Here we present the case report of a 93-year-old male who underwent radical prostatectomy but eventually suffered from a previously undescribed recurrence of prostatic adenocarcinoma with distant cutaneous metastases to proximal right lower leg.
Prostate carcinoma metastatic to the skin as an extrammamary Paget’s disease
2012
Aim: The current paper describes a case of prostatic adenocarcinoma metastatic to the skin presenting as an extrammamary Paget's disease, a very rare and poorly characterised morphological entity. We report a case of prostatic carcinoma metastatic to skin showing a pattern of extramammary Paget's disease which has not been clearly illustrated in the literature Case presentation: A 63 year-old man with prostatic adenocarcinoma developed cutaneous metastases after 16 years. The inguinal metastases were sessile and 'keratotic.' The tumour displayed solid, glandular areas as well as a polypoid region suggestive of extramammary Paget's disease were identified.
Prostate Small Cell Carcinoma and Skin Metastases: A Rare Entity
Medical Principles and Practice, 2008
Prostate cancer is the second leading cause of cancer deaths in men; approximately 95% of prostate carcinoma is adenocarcinoma . Small cell carcinoma of the prostate (SCCP) is rare and occurs only in about 0.5-2% of patients with prostate cancer. Adenocarcinoma usually accompanies SCCP [1] . The histogenesis of SCCP is not precisely known. According to one hypothesis, SCCP is derived from the malignant transformation of normal prostatic neuroendocrine cells . Another hypothesis postulates that SCCP is derived from multipotential stem cells of the prostatic epithelium . Due to the nature of the totipotent basal cells of the prostate, SCCP may also develop from conventional adenocarcinoma of the prostate . Based on a previous report [4] , 47% of patients with SCCP present with recurrence of conventional adenocarcinoma, and 17.7% presented with combined adenocarcinoma. SCCP is aggressive and usually metastatic at diagnosis ; however, metastases to skin are rare.
Cutaneous metastasis in a patient with multiple malignancies
Clinical and Experimental Dermatology, 2018
An 85-year-old woman presented with a 6-week history of painful eruptive papules affecting her lower abdomen. The pain was sufficiently severe to cause functional impairment with activities of daily living, and exerted a significant burden on her quality of life. Her medical history included cutaneous squamous cell carcinoma, melanoma, ovarian papillary serous adenocarcinoma and breast cancer (diagnosed radiologically without histological subtyping). Physical examination demonstrated hard papules and plaques affecting the right lower abdomen, mons and labia majora, many of which were tethered (Fig. 1). Histopathological findings Biopsy of a representative papule was consistent with cutaneous metastasis (Fig. 2). Histopathology demonstrated an infiltrating adenocarcinoma composed of ducts and glands. Lesional cells showed pleomorphic nuclei and prominent eosinophilic nucleoli. Several mitotic figures and apoptotic bodies were identified. The cells were positive for CK7, CA125, WT1, 34BE12, Pax8 and ER, and negative for Gata-3, PR, SOX-10, S100 and CK20.
Cutaneous metastasis: An unusual presenting feature of urologic malignancies
Urology Annals, 2016
Urological malignancies are well known for their ability to metastasize widely. The incidence of cutaneous metastasis from all urologic malignancies has been reported to be 0.73-1.3% with the primary most commonly being renal cell carcinoma followed by carcinoma bladder, adenocarcinoma prostate, and testicular germ cell tumor in decreasing order of frequency. Metastasis to the skin is unusual and has been predominantly reported as a late manifestation of the disease. We describe two patients with urologic malignancies who had cutaneous metastasis as their initial presenting feature.