Metastatic thyroid cartilage lesion from prostatic adenocarcinoma on ⁶⁸Ga-prostate-specific membrane antigen positron emission tomography-computed tomography scan: Case series

Abstract

Prostate cancer usually metastasizes to regional lymph nodes and bone. Laryngeal cartilage metastases are very rare and only few cases have been published so far describing thyroid cartilage metastatic lesions from prostate cancer. Here, we describe 5 cases of carcinoma prostate, 3 staging and 2 follow-up, where 68 Ga-prostate-specific membrane antigen positron emission tomography/computed tomography (PET/CT) scan revealed multiple skeletal lesions along with thyroid cartilage metastasis. Initially, laryngeal cartilage metastases remain asymptomatic and in later stages patients present with symptoms. These metastatic lesions to thyroid cartilage are rare entities and can often easily be missed on conventional imaging. PET-CT imaging has overcome this diagnostic problem due to its ability to provide for both anatomical and functional imaging.

Unusual Sites of Visceral Spread in Prostate Cancer: A Prostate-Specific Membrane Antigen–Based Theranostic Imaging Series

“…4,5 Age-related enchondral ossification increases the vascular supply of the tissue, increasing the risk of metastasis. 6 FIGURE 4. 68 Ga-PSMA PET/CT done before radioligand therapy in a 61-year-old patient with metastatic PC revealed new skeletal and cutaneous nodules (B-D, arrows), in addition to previously known primary lesion, abdominopelvic and biopsy-proven inguinal lymph nodal metastases (A-D).…”

“…Metastasis to the cartilage, being an avascular structure, is rare with any cancer, particularly in PC 4,5. Age-related enchondral ossification increases the vascular supply of the tissue, increasing the risk of metastasis 6.…”

Two-year follow-up of a thyroid cartilage metastasis from prostate cancer: A case report

“…In the literature, few case reports describe metastatic lesions to the thyroid cartilage, with the first case published in 1954 [6] . Identifying both common and uncommon locations of metastases has increased since the implementation of prostate-specific membrane antigen positron emission tomography/computed tomography (PSMA PET/CT) scan which is highly sensitive [7] . Unfortunately, when the thyroid cartilage is involved, the patient's prognosis is expected to be poor as it indicates extensive metastases [7] .…”

Prostate-Specific Membrane Antigen PET/CT Detection of Prostate Cancer Metastasis to Thyroid and Cricoid Cartilages

“…4 Of the previously reported cases, most were detected using the 68 Ga-PSMA PET/CT; however, some reports have also used conventional CT imaging, MRI, and 18 F-fluorocholine PET/CT modalities. [5][6][7][8][9][10] Here, we present 4 patients with metastatic lesions to thyroid and cricoid cartilages detected on PSMA PET/CT at our institution over the span of 19 months. This limited data set suggests that the incidence of prostate cancer metastasis to the thyroid and cricoid cartilages may be far more common than previously presumed.…”

“…As metastases typically spread through the bloodstream and lymphatic system, metastatic lesions are unlikely to be found in such tissue 4. Of the previously reported cases, most were detected using the 68 Ga-PSMA PET/CT; however, some reports have also used conventional CT imaging, MRI, and 18 F-fluorocholine PET/CT modalities [5][6][7][8][9][10]. Here, we present 4 patients with metastatic lesions to thyroid and cricoid cartilages detected on PSMA PET/CT at our institution over the span of 19 months.…”