Intracranial metastases due to prostatic carcinoma

Abstract

From 1973 to 1982, 189 patients were treated at the Dartmouth‐Hitchcock Medical Center for Stage C or D prostatic carcinoma. In eight of these cases (4.2%), there was clinical or pathological evidence for intracranial metastases. The condition of subdural neoplastic spread, not from contiguous bone, was identified in five cases, two of which were suspected before death. Four of these five patients were thrombocytopenic or pancytopenic at the time of the diagnosis. Intraparenchymal brain metastases were identified in six cases. Cerebellar, temporal bone, cavernous sinus, and splenium infiltration by tumor were unusual findings in individual cases. The results of chest x‐rays and respiratory status were poor predictors of lung metastases in four of five patients on whom autopsies were performed. This article describes the spectrum of radiographic and pathologic findings of intracranial prostatic carcinoma, and suggests that the likely mechanism of brain metastasis in these cases is by the dural veins and Virchow‐Robin spaces.

Brain metastasis from prostate carcinoma

“…The large number of patients with infratentorial involvement in this series follows the trend in the literature, which reports 11 cases of cerebellar involvement 4,15,16,27,28,31,32 in the 46 patients reported through 1998. 4 -42 Because of the obscuring effect of bone artifact in the posterior fossa on CT of the brain, tumor in this location may actually be underreported when CT is the primary imaging method used.…”

Dural metastases with subdural hematoma from prostate cancer

“…Haematogenous spread of cancer cells to the dura from systemic malignant disease has also been suggested 24 . Autopsy series 24,25 have found that most of the prostate cancer cases have associated lung involvement, especially lymphangitic and intravascular spread, implying a heavy vascular tumour burden 25 . There have been occasional reports of surgical intervention for subdural metastases in prostate cancer with varying degrees of success 24 .…”

Metástase cerebral como manifestação inicial de adenocarcinoma de próstata: Relato de dois casos

“…Os locais do SNC mais acometidos pelo adenocarcinoma de próstata são, em ordem decrescente 3,4,7 , leptomeninges, hemisférios cerebrais e cerebelo, sendo rara a sua localização no tronco cerebral. Os sinais e sintomas de metástase cerebral por adenocarcinoma de próstata não podem ser diferenciados de lesões metastáticas decorrentes de outros órgãos 1,4 .…”

“…Os sinais e sintomas de metástase cerebral por adenocarcinoma de próstata não podem ser diferenciados de lesões metastáticas decorrentes de outros órgãos 1,4 . Os sintomas mais comuns são déficit motor, cefaléia e crises convulsivas 3 . No diagnóstico das metástases cerebrais, são de grande valia a tomografia computadorizada e a ressonância nuclear magnética 6,9 .…”