Carcinoma of the Prostate: Brain Stem Metastasis as the Only Site of Spread

Abstract

Our case involved only brain stem metastasis, probably implicating Batson's direct route of the paravertebral venous pathway.

A brainstem paraneoplastic syndrome associated with prostate cancer

“…Our patient had no evidence of metastatic disease, although two of the clinical features he had, namely, extraocular muscle palsy15 16 and dysphagia,17 may be seen with metastatic prostate cancer, and isolated brainstem metastases have been reported in at least three patients with prostate carcinoma 18. The initial transient resolution of his symptoms with IVIG and IVMP, the absence of abnormalities suggestive of brainstem metastasis on MRI, and the normal studies for metastasis, such as PET, CT and bone scans and normal PSA, mitigate strongly against metastatic disease as the cause.…”

Brain metastasis from prostate carcinoma

“…58 There have only been 4 reported cases of prostatic metastases to the brainstem. 20,30,37,40 Brainstem metastases were seen in 2 patients in our series. Another 3 patients in our series had metastatic disease only to the brain, 1 of whom had metastases specifically to the hypothalamus and the right temporal lobe; the other 2 had multiple frontal metastases.…”

Biopsy-Proven Brain Metastases from Prostate Adenocarcinoma on 68Ga PSMA PET/CT: Case Series and Review of the Literature

“…31 patients (68.9%) had one or more metastatic brain lesions in the supratentorial compartment [7,[9][10][11][12][13]16,[18][19][20][21][22][23][24][25], 11 patients (24.4%) in the infratentorial compartment [8][9][10][13][14]17,23,26] and 3 patients (6.7%) in both compartments [27][28][29]. Two patients with lesions in the cavernous sinus were excluded.…”