Brain Metastasis From Prostate Adenocarcinoma: Case Report and Review of Literature

Abstract

It is rare for prostate carcinoma to metastasize to the central nervous system. It often represents a terminal event with death in one year frequently due to the advanced systemic disease. Starting by a case report, we also reviewed the relevant literature to focus on this uncommon entity from epidemiology to clinical manifestation and therapeutic strategies. In this article, a case of multiple brain prostate metastasis is reported and a review of relevant literature is also discussed. Treatments available for intracranial metastasis include neurosurgery, external beam radiation and hormonal manipulation. Surgery associated with whole brain radiotherapy seems to be effective in the control of brain lesions both relieving neurological symptoms and prolonging survival, even if prognosis remains dismal. From this case, we concluded that brain metastasis from prostate carcinoma is a rare, terminal event with death in one year frequently due to the advanced systemic disease. A better understanding of the biology of prostate carcinoma will help clarify the basis for its metastasis to the brain.

Prostate Adenocarcinoma with Brain Metastasis: A Surveillance, Epidemiology, and End Results Database Analysis 2010-2015

“…Prostate cancer metastasis disseminates predominantly to the bones (87%), followed by distant lymph nodes (10.6%); however, it can eventually spread to other organs such as the liver (10.2%), lungs (9.1%), and brain [ 1 ]. The most common site for brain metastasis is in the leptomeninges, followed by the cerebrum and cerebellum [ 2 , 3 ]. In 1940, Dr. Oscar Vivan Batson first discovered the importance of the venous plexus (which was then named the Batson’s venous plexus) in the human body [ 4 ], which is a network of veins connecting the paravertebral veins to the pelvic veins and the thoracic veins to the intraspinal (basivertebral) veins [ 5 ].…”

Prostate carcinoma mimicking a sphenoid wing meningioma

“…However, our case is unique in that metastatic lesions are generally much smaller and often arise in the context of a known history of malignancy (as opposed to an otherwise healthy patient, as was the case here). Moreover, metastatic lesions arise in atypical locations for a meningioma; as illustrated by our case, the lateral sphenoid wing is a very rare site of predilection for prostate metastases, as evidenced by only one other report in the literature [4] . Unfortunately, advanced prostate cancer patients with dural metastases have been reported to have poor overall prognosis and survival [5] .…”

Brain metastases in patient with prostate cancer found in 18F-choline PET/CT

“…Their incidence at autopsy varies from 0.4% to 4.4% but is, however, expected to increase with improving patient survival. Brain metastases are mostly located in the leptomeninges (67%), cerebrum (25%) and cerebellum (8%) and usually occur in patients with end-stage disease who already have lesions in the skeleton, lymph nodes, lungs and liver [9][10][11][12].…”

“…Brain metastases are rare and usually appear many years after initial diagnosis [8]. However, their incidence seems to be more frequent than in the past, possibly because of the advances in the CRPC treatment that have prolonged patients' survival [9,10].…”