Esophageal metastasis from prostate cancer: Diagnostic use of reverse transcriptase-polymerase chain reaction for prostate-specific antigen

Abstract

An extremely rare case of esophageal metastasis from prostate cancer is reported. A 65-year-old man presented with anorexia and back pain. Upper gastrointestinal X-ray fluoroscopy and endoscopy revealed a shallow longitudinal ulcer, with converging mucosal folds, approximately 5 cm above the esophagogastric junction. The histological diagnosis of the biopsied specimen was adenocarcinoma. Blood biochemistry revealed elevated serum prostate-specific antigen (PSA) and gamma-seminoprotein levels. Ultrasonography of the prostate disclosed a hypoechoic lesion in the left lobe, and needle biopsy led to the diagnosis of prostatic adenocarcinoma. Since there was no finding suggestive of a primary lesion, apart from that in the prostate, we conducted reverse transcriptase-polymerase chain reaction (RT-PCR) for PSA. PSA-positive mRNA was demonstrated in the tissue of the esophageal tumor. There are three reports on metastasis to the esophagus from prostate cancer, but this is the first case of esophageal metastasis from prostate cancer without any evidence of metastasis to other organs. The importance of RT-PCR for the diagnosis of primary lesions of metastatic cancer is discussed.

Transcriptome Network Analysis Reveals Potential Candidate Genes for Esophageal Squamous Cell Carcinoma

“…Furthermore, PSApositive mRNA was demonstrated in the tissue of the esophageal tumor by RT-PCR. Previous reports also suggested esophagus cancer might result from prostate cancer metastasis (Nakamura et al, 1997). Annexin I is a pleotrophic, calcium-dependent phospholipid binding protein.…”

Gastrointestinal Bleeding from Metastatic Prostate Adenocarcinoma to the Stomach

“…Six of the patients were known to have prostate cancer prior to the diagnosis of gastric metastases, and prostate cancer was diagnosed in one patient after upper endoscopy with biopsy and confirmation on immunohistochemical staining 8-13. Although rare, metastases to other sites in the GI tract, such as the small bowel and esophagus, have been reported 14,15. The exact mechanism of GI metastasis is unclear, but it may include lymphatic, hematogenous, and direct spread 8…”

Metastatic prostate cancer masquerading clinically and radiologically as a primary caecal carcinoma

“…Widespread visceral involvement is quite rare. Some unusual sites of spread have been described in literature as the parotid gland[3], oesophagus[4], vocal cords[5], larynx[6], lung &bronchus[7], stomach[8], liver[9], skin[10], umbilicus [11], sphenoid sinus[12], cranium[13], meninges[14], testes[15], penis[16], breast[17], mediastinum[18], thymus [19], orbit[20], uveal tract[21], brain[22], cerebellum[23] and bones[24]. Rectal seeding on needle biopsy[25] and direct involvement occasionally occurs [26], but distant metastasis to the bowel is quite rare (prevalence 1–4% in autopsy series)[27].…”