Isolated Solitary Lung Nodule in a Patient With Idiopathic Pulmonary Fibrosis and Concomitant Prostate Cancer: A Challenging Diagnosis

Abstract

Prostate cancer is the most commonly diagnosed malignancy and the second most common cause of death in men after lung cancer. Isolated pulmonary metastasis from prostate cancer, without bone or lymph node involvement, is rare and accounts for less than 1% of cases. The diagnosis of solitary lung metastasis is even more challenging in patients with concomitant pulmonary disease and often mandates tissue biopsy from the lung nodule. We herein present a case of an elderly man with idiopathic pulmonary fibrosis who presented with a solitary lung nodule three years after a laparoscopic radical prostatectomy for localized prostate cancer. Initially thought as a primary lung lesion secondary to his pulmonary fibrosis, further workup and ultimately a lung segmentectomy proved a metastatic prostatic adenocarcinoma. The serum prostatic specific antigen dropped to nadir following resection, and he remained stable six months later.

Prostate Cancer Lung Metastasis: Clinical Insights and Therapeutic Strategies

“…PCa cells in lung metastasis often retain the glandular features seen in the primary tumor, aiding in their identification. The majority of lung metastasis in prostate cancer arise from prostate adenocarcinoma, given its status as the most prevalent histological subtype of PCa [14,15,49,50]. Nevertheless, less common histological subtypes, such as small cell carcinoma and neuroendocrine carcinoma of the prostate, have been documented [51][52][53][54].…”