The role of resection of pulmonary metastases from prostate cancer: a case report and literature review

Wallis, Christopher J.D.; English, John; Goldenberg, S. Larry

doi:10.5489/cuaj.10136

Cited by 33 publications

(25 citation statements)

References 28 publications

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“…However, the significance of this finding might vary depending on the specific clinical scenario. For some patient groups, the detection rate of the contrast-enhanced VIBE sequence might be sufficient, for example, in prostate cancer patients with early biochemical relapse, because in this group lung metastases are rare and when present usually they are larger than 1 cm (26). Also many patients might already present with diagnostic CT images including the chest before undergoing the PET/MR examination.…”

Section: Discussionmentioning

confidence: 99%

PET/MR Imaging in the Detection and Characterization of Pulmonary Lesions: Technical and Diagnostic Evaluation in Comparison to PET/CT

et al. 2014

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Fully integrated PET/MR imaging holds great promise as a novel hybrid imaging modality in oncology and might offer advantages to PET/CT in many instances, especially because of the superior softtissue contrast of MR imaging, compared with CT. However, lung metastases are a frequent finding in oncologic patients, and for imaging of the lung CT is still the modality of choice. Thus, we prospectively evaluated differences in quality, detection rate, size, and radiotracer uptake of pulmonary lesions in 18 F-FDG PET/CT and PET/MR imaging. Methods: Institutional review board approval and informed consent were obtained. Forty patients (23 men, 17 women; mean age ± SD, 53.2 ± 13.1 y) underwent a single-injection dualimaging protocol with 18 F-FDG PET/CT and PET/MR imaging. Pulse sequences for the lung included T1-weighted VIBE (volumetric interpolated breath-hold examination) Dixon for attenuation correction and contrast-enhanced VIBE pulse sequences. All patients underwent a diagnostic CT of the chest in deep inspiration, which also served as a standard of reference. Two masked readers assessed in consensus all images randomly concerning quality, detection, standardized uptake value (SUV), and size of pulmonary nodules. Correlations were performed using linear correlation. Results: Overall, 47 pulmonary lesions (mean size ± SD, 10.0 ± 11.4 mm; range, 2-60 mm) in 25 of 40 patients were detected. The PET datasets of PET/MR imaging and PET/CT revealed 22 of 47 pulmonary lesions with focal 18 F-FDG uptake. SUVs of lung lesions in PET/MR imaging and PET/CT correlated significantly (R 5 0.9; P 5 0.0001) and showed no significant difference (mean SUV PET/MR imaging, 6.3; PET/CT, 5.1; P 5 0.388). There was a significantly lower image quality comparing Dixon and VIBE sequence with CT whereas PET from PET/CT and PET from PET/MR imaging showed the same results (2.8). Dixon images detected 15 of 47 lung lesions whereas VIBE images detected 32 of 47 lesions, respectively. The detection rates for small lung lesions less than 1 cm in diameter (n 5 33) of MR imaging was significantly lower, with a detection rate of 9 of 33 for the Dixon sequence and 15 of 33 for the VIBE sequence (P , 0.0001 for VIBE and Dixon sequence). There was a high correlation of pulmonary lesion size of CT versus VIBE (R 5 0.97). Conclusion: PET image quality and detection rate of 18 F-FDG-positive lung lesions in PET/MR imaging is equivalent to PET/CT despite differences in attenuation-correction techniques. Additionally, a high linear correlation coefficient in the SUVs for the PET images from PET/CT and PET/MR imaging was found. The detection rate of lung lesions can be significantly improved by adding a diagnostic contrast-enhanced VIBE sequence to the PET/MR imaging protocol. However, the detection rate of small lung lesions is still inferior, compared with PET/CT with diagnostic CT of the chest. Pul monary lesions are a common incidental finding in imaging studies although their evaluation is complex and still remains a diagnostic challenge. Advances in C...

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Section: Discussionmentioning

confidence: 99%

PET/MR Imaging in the Detection and Characterization of Pulmonary Lesions: Technical and Diagnostic Evaluation in Comparison to PET/CT

et al. 2014

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“…Wallis and colleagues, in their recent literature review, found a total of only 18 cases of solitary metastatic Pca to lung and 15 cases of multiple metastases without osseous or lymphatic involvement (2). Until now, androgen deprivation therapy (ADT) is the cornerstone of treatment for PCa patients diagnosed with metastatic progression following primary treatment, although the optimal timing and schedule of ADT is still under debate in this setting (3).…”

Section: Discussionmentioning

confidence: 99%

Pulmonary recurrence from prostate cancer and biochemical remission after metastasis directed therapy. A case report

Boschian

Rizzo

Zandonà

et al. 2018

Arch Ital Urol Androl

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We report a case of a 69-years-old man who presented with a solitary 1 cm nodule in the lower lobe of the left lung almost 3 years after radical prostatectomy for pT3aN0M0, Gleason score 4+3 disease, without evidence of osseous or lymphatic spread. Surgical resection of the pulmonary lobe confirmed the metastatic nature of the lesion, with subsequent reduction of serum PSA to undetectable levels. After 2 years from the metastasis resection, serum PSA is still undetectable, without the necessity of additional treatments. Solitary pulmonary metastases from prostate cancer (Pca) are rare in clinical practice, with only 29 previous cases described besides the one that we present.KEY WORDS: Prostate cancer; Recurrence; PSA. of the left lung, strongly suggesting a tumor. The patient was suspected to have a secondary lung metastasis. Since there was no evidence of metastatic disease in the remaining workup, the patient elected to undergo a thoracoscopic segmental resection with lymph node dissection. Histopathological examination revealed Pca metastasis with negative lymph nodes (Figure 1). Subsequently, PSA serum level dropped to undetectable levels (less than 0.05 ng/ml) and remained undetectable for more than 36 months. DISCUSSIONThe incidence of lung metastases from Pca is reported from 5% to 27%; however, it is a very rare condition in the absence of gross osseous or lymphatic involvement (1). Wallis and colleagues, in their recent literature review, found a total of only 18 cases of solitary metastatic Pca to lung and 15 cases of multiple metastases without osseous or lymphatic involvement (2). Until now, androgen deprivation therapy (ADT) is the cornerstone of treatment for PCa patients diagnosed with metastatic progression following primary treatment, although the optimal timing and schedule of ADT is still under debate in this setting (3).

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“…3 In a clinical study of 1290 patients diagnosed with prostate cancer, 48 patients had lung metastases, with only 11 patients (0.86%) having solitary nodule. 4 There have been several reports of isolated multiple pulmonary metastases; 5 however, none have reported lung metastases of prostate cancer and primary lung cancer detected at the same time. Our case is the first to present these unique characteristics.…”

Section: Discussionmentioning

confidence: 99%

“…Both surgical excision and androgen-deprivation therapy have resulted in some regression or resolution of pulmonary nodules. 5 It was reported, in a case report, that the resection of a solitary lung metastasis of prostate cancer resulted in 12 years of biochemical remission without additional therapy. 6 These findings suggest that although lung metastases are usually regarded as a manifestation of systemic disease, their early removal may be a management option for prostate cancer patients with pulmonary nodules.…”

Section: A B C D E Fmentioning

confidence: 99%

Coincident detection of lung metastasis of prostate cancer and primary lung cancer: A case report

Muro

Kosaka

Hato

et al. 2015

CUAJ

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Cite as: Can Urol Assoc J 2015;9(7-8):E524-6. http://dx.doi.org/10.5489/cuaj.2376 Published online July 17, 2015. AbstractWe report an extremely rare case of 79-year-old man, who was discovered with coincidental lung metastasis of prostate cancer and primary lung cancer. The patient presented with low prostatespecific antigen and two lung lesions: one in the right lower lobe, and one in the right upper lobe, 3 years after he was treated with external beam radiotherapy for Gleason score 4+3=7, cT3aN0M0 prostate cancer. A computed tomography-guided needle biopsy of a nodule in the right lower lobe revealed suspicious metastasis of prostate cancer. Thoracoscopic excisions of both lesions were performed, and each lung lesion was diagnosed as being metastatic prostate cancer and primary lung cancer.

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The role of resection of pulmonary metastases from prostate cancer: a case report and literature review

Cited by 33 publications

References 28 publications

PET/MR Imaging in the Detection and Characterization of Pulmonary Lesions: Technical and Diagnostic Evaluation in Comparison to PET/CT

PET/MR Imaging in the Detection and Characterization of Pulmonary Lesions: Technical and Diagnostic Evaluation in Comparison to PET/CT

Pulmonary recurrence from prostate cancer and biochemical remission after metastasis directed therapy. A case report

Coincident detection of lung metastasis of prostate cancer and primary lung cancer: A case report

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