Isolated Peritoneal Metastasis of Prostate Cancer Presenting with Massive Ascites: A Case Report

Abstract

The peritoneal carcinomatosis of prostate cancer without bone or other visceral organ involvement is extremely rare. We report a case of an isolated peritoneal metastasis of prostate cancer in a patient without other metastatic sites and a history of prostate surgery. A 63-year-old male with locally advanced prostate cancer without known distant metastasis on androgen deprivation therapy presented with abdominal distension that had persisted for a month. Abdominopelvic computed tomography (CT) showed gastric wall thickening and a moderate amount of ascites. The gastroscopy showed hyperemic mucosal patches on the antrum body. A cytological examination of the ascites fluid was negative for malignant cells. Diagnostic laparoscopy showed multiple nodules in the peritoneum. A biopsy was performed. Histological findings were compatible with metastatic carcinoma of the prostate, which was immunohistochemically positive for pan-cytokeratin, the androgen receptor, and prostate-specific antigen (PSA). The patient was then treated with abiraterone acetate. After 1 month of treatment, both ascites and the PSA value decreased. We describe an extremely rare case of isolated peritoneal carcinomatosis from prostate cancer without any organ metastasis or history of surgery. Clinicians should be aware of these very rare metastases of prostate cancer. Hormonal therapy may be helpful for such cases.

Peritoneal Metastases From Prostate Carcinoma Treated With 177Lu-PSMA-I&T

“…Four months after the fourth cycle, PSA decreased to 7.0 μg/L and the general condition improved significantly. Omental and peritoneal metastases of prostate cancer are a rare entity, especially without other visceral or bone metastases 2,3. The exact mechanism is not known, but a relation to previous surgery is possible in this patient, 2 who had a history of prostatectomy.…”

68Ga-PSMA-11 PET/CT in a Case of Isolated Parietal Peritoneal Metastasis From Prostate Adenocarcinoma

“…2 Metastatic prostate cancer limited to the peritoneum is extremely rare. [3][4][5] On CT, peritoneal metastases of prostate cancer may appear as solitary or multiple nodules, diffuse soft tissue thickening, and fat stranding of the peritoneum, mesentery, or omentum with or without ascites. 6 On PSMA PET, peritoneal metastases of prostate cancer can show focal, multifocal, or diffuse PSMA uptake.…”

“…Peritoneal metastasis of prostate cancer is rare accounting for 7% of the patients with hematogenous metastasis of prostate cancer 1 and is often associated with other metastatic sites 2 . Metastatic prostate cancer limited to the peritoneum is extremely rare 3–5 . On CT, peritoneal metastases of prostate cancer may appear as solitary or multiple nodules, diffuse soft tissue thickening, and fat stranding of the peritoneum, mesentery, or omentum with or without ascites 6 .…”

Peritoneal Carcinomatosis From Metastatic Prostate Cancer Identified on 68Ga-Prostate-Specific Membrane Antigen PET/CT

“…Peritoneal metastasis is extremely uncommon in prostate cancer cases, particularly without osseous involvement, and presents a poor prognosis. 2 To date, only a few cases of isolated peritoneal metastasis from prostate cancer have been described in the literature. [3][4][5][6][7][8][9][10][11][12] Rapoport and Omenn 13 performed autopsies on 523 prostate cancer patients and found only 13 cases of isolated peritoneal metastases.…”

“…Prostate cancer is the second leading male malignancy cause of death 1 with an overwhelming predilection for metastases to involve bones. Peritoneal metastasis is extremely uncommon in prostate cancer cases, particularly without osseous involvement, and presents a poor prognosis 2. To date, only a few cases of isolated peritoneal metastasis from prostate cancer have been described in the literature [3][4][5][6][7][8][9][10][11][12].…”