Brain Metastases from Prostate Cancer: An 11‐Year Analysis in the MRI Era with Emphasis on Imaging Characteristics, Incidence, and Prognosis

Abstract

Background and Purpose Brain metastases from prostate cancer are uncommon and their imaging appearance has not been well defined. The main objectives of this study were to evaluate the incidence, MRI characteristics, and prognosis of parenchymal brain metastases originating in prostate cancer. Methods We retrospectively identified 21 patients with prostate cancer and evidence of brain metastases from 2000 to 2010. We reviewed the initial brain MRI scans and characterized the lesions according to location and appearance on MRI, while also determining patient demography, staging, and survival. Results The incidence of brain metastasis from prostate cancer was .16%. At the time of brain metastasis detection, 95% of the patients had concurrent osseous metastases, 86% lymph node metastases, and 76% liver and/or lung metastases. Brain metastases were multifocal in 71% of patients, hemorrhagic in 33%, diffusion restricted in 19%, and partially cystic/necrotic in 19%. The median overall survival after brain metastasis detection was 2.8 months. Conclusions Brain metastasis from prostate cancer remains a rare phenomenon that most frequently occurs in the setting of widely disseminated bone and soft tissue disease. Patients with nonadenocarcinoma pathology are more likely to develop brain metastases. The MRI appearance is highly variable and prognosis is poor.

Insidious enemy: downside to prolonged survival in prostate cancer

“…Brain metastases from prostate cancer, although rare, often at diagnosis have extensive bone and soft tissue dissemination 5. Notably, the most common primary site for cancer metastases to the clivus is the prostate 6.…”

Headache Caused by Brain Metastases of Castration-resistant Prostate Cancer during Cabazitaxel Therapy

“…[3][4][5][6][7][8][9] The mean age at the detection of brain metastases ranged from 61.3 to 68.8 years. [4][5][6] Initial symptoms often result from increased intracranial pressure and diffuse cortical disorder and include delirium (51%), headache (36%), and memory deficits (17%). 5 Clinically, brain metastases present with signs of increased intracranial pressure (headache, nausea, and vomiting), changes in mental status, seizures, or focal signs.…”

“…10 Overall, 95% of patients with brain metastases of prostate cancer had concurrent osseous metastases. 4,5 The mean overall survival after diagnosis of brain metastases of prostate cancer ranged from 1 to 9.2 months. [4][5][6]9,11 In cases where brain metastases were treated, the mean overall survival ranged from 3.5 to 9.2 months.…”

“…4,5 The mean overall survival after diagnosis of brain metastases of prostate cancer ranged from 1 to 9.2 months. [4][5][6]9,11 In cases where brain metastases were treated, the mean overall survival ranged from 3.5 to 9.2 months. 5,6,9,11 The median interval from the diagnosis of prostate cancer to the detection of brain metastases ranged from 21.9 to 45.6 months.…”

“…5,6,9,11 The median interval from the diagnosis of prostate cancer to the detection of brain metastases ranged from 21.9 to 45.6 months. 4,6,8,9 We performed a literature search for reports on intracranial metastasis of prostate cancer published after 2000. The detailed treatment course was obtained for eight cases [11][12][13][14][15][16][17][18] in which the brain metastases were sensitive to hormonal therapy.…”