A Rare Presentation of Metastasis of Prostate Adenocarcinoma to the Stomach and Rectum

Soe, Aye Min; Bordia, Sonal; Xiao, Philip; Lopez-Morra, Hernan; Tejada, Juan; Atluri, Sreedevi; Krishnaiah, Mahesh

doi:10.5230/jgc.2014.14.4.271

Cited by 13 publications

(25 citation statements)

References 15 publications

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“…Metastatic gastric tumor of prostate cancer is rare and only 13 cases have been reported to date [2][3][4][5][6][7][8][9][10][11][12][13][14]. Time to metastasis to the stomach from a diagnosis of primary prostate cancer varies (identified simultaneously to 10 years later).…”

Section: Discussionmentioning

confidence: 99%

“…Among other cancers, bone and the lung are the most common distant metastatic sites in prostate cancer, which is rarely observed in the stomach/bowel (1.8%) [2]. Thirteen cases of metastatic prostate cancer to the stomach were reported in the English literature to date [3][4][5][6][7][8][9][10][11][12][13][14]. Most were diagnosed by biopsy with immunohistochemistry (IHC) of prostatespecific antigen (PSA), but only one case diagnosed as primary gastric cancer because of negative PSA staining was resected endoscopically [12].…”

Section: Introductionmentioning

confidence: 99%

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A rare case of PSA-negative metastasized prostate cancer to the stomach with serum CEA and CA19-9 elevation: a case report

et al. 2020

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Background Metastatic cancer to the stomach is relatively rare. Prostate-specific antigen (PSA) is a reliable biomarker used in the screening and management of patients with prostate cancer. However, it is difficult to definitively diagnose a PSA-negative metastatic gastric tumor of prostate cancer because the cancer sometimes resembles primary gastric cancer in clinical images. It is also difficult to distinguish metastatic cancer from primary cancer even in the pathological examination of biopsy samples when the lesion is poorly differentiated adenocarcinoma. There is a possibility that the characteristics of the cancer are changed during treatment such as chemotherapy or radiation therapy. Therefore, careful consideration is required for surgical indication. Case presentation A 60-year-old male underwent radical prostatectomy and subsequent radiation therapy for advanced prostate cancer (pT3N1M0) 10 years previously, and hormone therapy was started for metachronous multiple bone metastasis 10 months before. Upper gastrointestinal endoscopy revealed an irregular depressed lesion with a convergence of folds at the greater curvature of the upper gastric body. Biopsy showed poorly differentiated adenocarcinoma that was negative for PSA upon immunohistochemistry. He had high serum carcinoembryonic antigen (CEA) (946.1 ng/ml) and carbohydrate antigen 19-9 (CA19-9) (465.1 U/ml) levels with no elevation of PSA (0.152 ng/ml). The tumor was diagnosed as primary gastric cancer based on the clinical imaging and pathological examination of the biopsy sample including the PSA staining. Based on the diagnosis, laparoscopic proximal gastrectomy with lymphadenectomy was performed. However, pathological examination of the resected specimen revealed poorly differentiated adenocarcinoma that was positive for other prostate markers such as androgen receptor. Thus, the patient was diagnosed with metastasized prostate cancer to the stomach. Conclusions We report a case of metastatic gastric cancer of prostate cancer 10 years after radical prostatectomy. In the present case, it was difficult to diagnose a metastatic gastric tumor of prostate cancer preoperatively, because of its resemblance to primary gastric cancer without PSA expression and no serum PSA elevation. Although a rare case entity, it is important to consider the possibility of a metastatic gastric tumor when the surgical indication is determined in cases with another co-existing cancer.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

A rare case of PSA-negative metastasized prostate cancer to the stomach with serum CEA and CA19-9 elevation: a case report

et al. 2020

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“…Spread to the regional lymph nodes is estimated to be seen in approximately 1 out of 10 cases. Visceral organs such as the lungs, liver, and adrenals are all documented common sites of metastasis [6,7] Spread to soft tissue is quite rare and involvement of the chest wall is a very uncommon form of presentation [8][9][10][11].…”

Section: Discussionmentioning

confidence: 99%

Adenocarcinoma of the Prostate Presenting as a Soft Tissue Metastasis: A Case Report and Review of Literature

Ajetunmobi

Dzuachii

Offor

et al. 2019

IJTDH

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Metastasis is the most frequent cause of mortality in cancer patients and symptoms related to a secondary deposit are a common form of presentation in malignancies. Cancers of the prostate commonly present with metastasis to the vertebrae, and less commonly to the lungs and liver. Metastasis to soft tissue is extremely rare and a highly unlikely form of presentation. However, with rising cancer rates in the developing world, secondary tumors should be excluded when soft tissue masses are encountered.

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“…Imaging findings include a rectal mass or diffuse thickening of the rectal wall (Fig 17) (69)(70)(71). Histologic confirmation is required to differentiate rectal metastasis from a second primary rectal cancer.…”

Section: Patterns Of Systemic Metastasismentioning

confidence: 99%

Current Imaging Techniques for and Imaging Spectrum of Prostate Cancer Recurrence and Metastasis: A Pictorial Review

et al. 2020

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Relapsing level of prostate-specific antigen (PSA) after initial curative-intent local therapy for organ-confined prostate cancer is often the first sign of recurrence. However, PSA level recurrence does not enable accurate differentiation of locally recurrent tumor from metastatic disease or a combination of both. Metastatic prostate cancer most frequently involves bones and lymph nodes, followed by other organs such as the liver, lung, pleura, adrenal gland, ureter, peritoneum, penis, testis, and meninges. Conventional imaging including CT and bone scintigraphy has long been the standard of care but has limited sensitivity in depicting early local recurrence or metastatic disease. Multiparametric MRI has been shown to be more sensitive in detecting locally recurrent tumor in the prostatectomy bed as well as in situ recurrence in a prostate gland that has been treated with radiation therapy or thermal ablation. In addition, lesions detected with multiparametric MRI may be amenable to targeted biopsy for definitive diagnosis of recurrence. PET/ CT or PET/MRI using the U.S. Food and Drug Administration (FDA)-approved tracers carbon 11 choline or fluorine 18 fluciclovine has demonstrated markedly increased sensitivity and specificity for diagnosis of early metastatic disease such as small-volume lymph node metastasis, as have a range of investigational gallium 68 prostate-specific membrane antigen (PSMA) radioactive PET tracers. With recent advances in imaging modalities and techniques, more accurate early detection, localization, and characterization of recurrent prostate cancer have become possible. The authors present a contemporary review of the strengths and limitations of conventional and advanced imaging modalities in evaluation of patients with recurrent prostate cancer and a systematic review of the clinical and imaging features of locally recurrent and metastatic disease. ©

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A Rare Presentation of Metastasis of Prostate Adenocarcinoma to the Stomach and Rectum

Cited by 13 publications

References 15 publications

A rare case of PSA-negative metastasized prostate cancer to the stomach with serum CEA and CA19-9 elevation: a case report

A rare case of PSA-negative metastasized prostate cancer to the stomach with serum CEA and CA19-9 elevation: a case report

Adenocarcinoma of the Prostate Presenting as a Soft Tissue Metastasis: A Case Report and Review of Literature

Current Imaging Techniques for and Imaging Spectrum of Prostate Cancer Recurrence and Metastasis: A Pictorial Review

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