Incidental finding of metastatic prostatic adenocarcinoma of frontotemporal bone presenting as subdual hematoma: A case report and review of literature

Abstract

Introduction and important: Prostatic cancer is often prone to metastasis and bone invasion. Skull metastasis in prostate cancer is uncommon, accounting for less than 2% of all metastases. However, frontotemporal bone metastasis without dural or brain metastasis is rare. Case presentation Herein, we report the case of a 91-year-old male patient who presented with a sudden-onset dizziness, a fall to the ground, and gradual loss of consciousness. Computed tomography (CT) of the brain revealed an aggressive bony lesion secondary to locally advanced metastatic malignancy and subdural hematoma. Subsequently, he underwent decompressive craniectomy. Histopathological and immunohistochemical (IHC) examinations demonstrated metastatic prostatic adenocarcinoma (PCa). Although after treatment by a multidisciplinary team, unfortunately, the patient expired two months after the surgery and could no longer be traced. Clinical discussion In the majority of reported cases, CT scans of the brain are often mistaken for subdural hematoma or meningioma. The present case suggests is a preliminary incidental case of a single frontotemporal bony lesion. This is the first case described in the literature of incidental finding of metastatic PCa presenting with asymptomatic characteristics. Conclusion Awareness of the possibility of metastatic PCa involving the skull bones, as well as histopathological and IHC examinations, are important to arrive at a correct initial diagnosis.

Skull metastasis is a poor prognostic factor for prostate cancer patients with bone metastasis: a retrospective study based on a Chinese population

“…Noticeably, literature reviews showed a relatively higher metastatic rate to skull in PCa cancer patients [ 11 – 15 ]. As a distant metastasis site from the primary tumor, skull metastasis (SM) may be a sign of more aggressive disease and shorter survival rate after treatment [ 16 – 18 ]. However, the prognostic implication of SM in PCa patients is still not clear.…”