Brain metastasis from prostate cancer: A review of the literature with an illustrative case

Abstract

Introduction and importance: Brain metastasis of prostatic cancer is highly a rare condition. Its intracranial metastatic process and presentation are poorly understood and limited to case reports, making it challenging to detect and diagnose. We aim to highlight the rare case, brain metastasis of prostate cancer, and review the literature regarding the progress and therapies of prostatic cancer in the current era. The case of a prostate adenocarcinoma patient who acquired brain metastasis was outlined. In addition, we review the literature to discuss the main aspects of brain metastasis in prostate cancer. Case presentation: Herein, the patient was a 62-year-old male with metastatic prostate adenocarcinoma into the brain, which suffered from progressive language difficulties, mixed dysphasia, and right hemiparesis. Clinical discussion: Brain magnetic resonance imaging revealed a left frontoparietal mass, confirmed with an elevated PSA level. The group was resected, and after that, the patient was discharged with noticeable language and neurological improvement. Upon follow-up, after six months, a new asymptomatic left temporal lesion was observed and successfully treated with chemotherapy and radiotherapy. This case confirms that prostatic adenocarcinoma's possibility to spread into the brain. Conclusion: This report reviews the literature about prostate cancer brain metastasis, highlighting that although rare, it does occur and shouldn't be neglected, especially with the current progress in prostatic cancer therapies, which prolongs the patient's survival time, so those brain metastases out of prostatic cancer are expected to be a frequent clinical scenario. Therefore, follow-up of prostatic cancer male patients of 50 years old or more is necessary. Highlights Key message: The milestone of treating the cerebral metastasis of prostate cancer is early detection, early management, and follow-up.

Rare Isolated Cerebellar Metastases in Prostate Cancer: A Case Report with Review of Literature

“…3,4 They are commonly seen in cancers of the lung, breast, colon, kidney, and melanoma, and brain metastasis from prostatic cancer, especially adenocarcinomas, is extremely rare. 5 PC is the second most common cancer in males. Approximately 99% of PC cases are prostate adenocarcinomas, while other rare subtypes include squamous cell carcinoma, small cell carcinoma, stromal neoplasms, and neuroendocrine carcinoma, and lymphomas.…”

“…Because of the tendency to penetrate the dura mater and extend in the extradural or subdural space, these lesions could be mistaken for meningiomas, subdural hematomas, or abscesses on imaging. 5 The incidence of ante mortem diagnosed isolated brain metastases is extremely rare with less than 17 cases documented. Only one of these cases had isolated cerebellar metastases.…”

“… 3 4 They are commonly seen in cancers of the lung, breast, colon, kidney, and melanoma, and brain metastasis from prostatic cancer, especially adenocarcinomas, is extremely rare. 5 …”

“…Because of the tendency to penetrate the dura mater and extend in the extradural or subdural space, these lesions could be mistaken for meningiomas, subdural hematomas, or abscesses on imaging. 5 …”

The nerve growth factor-delivered signals in prostate cancer and its associated microenvironment: when the dialogue replaces the monologue

“…By crossing the bone marrow stroma, PC cells might establish metastasis in bone [ 121 ]. In less than 1% of cases, PC might metastasize to the brain [ 122 ].

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