Multiple metastases of androgen indifferent prostate cancer in the urinary tract: two case reports and a literature review

Masuda, Tsukasa; Kosaka, Takeo; Nakamura, Kazuto; Hongo, Hiroshi; Yuge, Kazuyuki; Nishihara, Hiroshi; Oya, Mototsugu

doi:10.1186/s12920-022-01267-z

Cited by 8 publications

(4 citation statements)

References 33 publications

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“…Our search of the PubMed database using the keywords "neuroendocrine prostate cancer," "BRCA2 mutation," and "Case" yielded 13 case reports. [10][11][12][13][14][15][16][17][18][19][20][21][22] Of these, 5 cases from 4 articles involved individuals who had no prior history of cancer and were administered olaparib (Table 1). [12,15,21,22] In terms of age and initial PSA levels, the patient was younger and had a significantly higher PSA value than did the other cases presented in the Table 1.…”

Section: Discussion and Literature Reviewmentioning

confidence: 99%

Brain metastasis in a patient with BRCA2-mutated treatment-related neuroendocrine prostate carcinoma and long-term response to radiotherapy and Olaparib: A case report and literature review

Uehara,

Obinata,

Hashimoto

et al. 2024

Medicine

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Background: A new subtype of prostate cancer called treatment-related neuroendocrine prostate carcinoma (t-NEPC) was added to the revised World Health Organization classification of prostate cancer in 2022. t-NEPC cases are increasing, and there is no established standard treatment. Methods: A 49-year-old male patient was referred to our department for dysuria. A rectal examination and a prostate biopsy revealed stony hardness and prostate adenocarcinoma, respectively. Imaging studies confirmed the presence of multiple bone and lymph node metastases. The patient was started on upfront treatment with androgen deprivation therapy and an androgen receptor signaling inhibitor, which resulted in a significant (>90%) decrease in prostate-specific antigen (PSA) levels. The patient experienced postrenal failure 6 months later, attributable to local disease progression. Concurrently, there was an elevation in neuron-specific enolase (NSE) levels and an enlargement of pelvic lymph node metastases, without PSA progression. Results: Biopsy specimen for cancer genome profiling revealed deletion of BRCA 2 and PTEN, AR amplification, and the presence of the TMPRSS2-ERG fusion gene. Based on increased NSE and BRCA2 mutations, a diagnosis of t-NEPC with BRCA2 mutation was eventually made. The patient received docetaxel chemotherapy and pelvic radiotherapy. Subsequently, he was treated with olaparib. His NSE levels decreased, and he achieved a complete response (CR). However, 18 months following the olaparib administration, brain metastases appeared despite the absence of pelvic tumor relapse, and the patient’s PSA levels remained low. Consequently, the patient underwent resection of the brain metastases using gamma knife and whole-brain radiotherapy but died approximately 3 months later. Conclusion subsections: Platinum-based chemotherapy is often administered for the treatment of t-NEPC, but there are few reports on the effectiveness of olaparib in patients with BRCA2 mutations. In a literature review, this case demonstrated the longest duration of effectiveness with olaparib alone without platinum-based chemotherapy. Additionally, the occurrence of relatively rare, fatal brain metastases in prostate cancer after a long period of CR suggests the necessity of regular brain imaging examinations.

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Section: Discussion and Literature Reviewmentioning

confidence: 99%

Brain metastasis in a patient with BRCA2-mutated treatment-related neuroendocrine prostate carcinoma and long-term response to radiotherapy and Olaparib: A case report and literature review

Uehara,

Obinata,

Hashimoto

et al. 2024

Medicine

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“…Clinically, AVPC is characterized by distinctive manifestations, such as predominantly visceral or lytic bone metastases and the presence of bulky tumor masses, frequently in the setting of low PSA level with high-volume tumor burden and early emergence of castration resistance [ 8 ]. While several clinical trials on AVPC have been reported, to our knowledge, there have been only two cases of AVPC documented in the English literature (Table 1 ) [ 9 , 10 ].…”

Section: Discussionmentioning

confidence: 99%

Aggressive variant prostate cancer with multiple subcutaneous metastases: a case report

Hoshino,

Kanao,

Miyama

et al. 2024

Int Canc Conf J

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A 71-year-old man with bone metastasis of hormone-sensitive prostate cancer was treated with androgen deprivation therapy and apalutamide. Radium-223 and radiation therapy were administered after it become castration resistant. Although prostate-specific antigen levels remained low, multiple subcutaneous metastases of neuroendocrine prostate cancer were observed. A review of the pre-treatment prostate needle biopsy revealed a small component with features suggestive of neuroendocrine differentiation. Phosphatase and tensine homolog loss and tumor protein p53 overexpression were observed, confirming the diagnosis of aggressive variant prostate cancer. Platinum-based chemotherapy was administered; however, the patient died 28 months after diagnosis. In this case, if the diagnosis of aggressive variant prostate cancer had been made at an earlier time by biopsy specimens, there might have been a possibility to improve the prognosis by the earlier introduction of the platinum-based regimen.

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“…When EPT develops adenocarcinoma, benign prostatic tissue surrounding cancer should be present, which can differentiate EPT adenocarcinoma from bladder metastases of PCa. Such bladder metastases are rare, with only 9 cases reported (Table 2 ) 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 ; the metastases were identified on MRI or computed tomography at the time of diagnosis of metastatic PCa or PSA elevation after radical prostatectomy or during hormonal therapy. In all cases, primary bladder cancer was initially suspected, yet TURBT revealed bladder metastases from PCa.…”

Section: Discussionmentioning

confidence: 99%

Adenocarcinoma in ectopic prostatic tissue at the trigone of urinary bladder

et al. 2023

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IntroductionEctopic prostatic tissue is prostatic tissue located distant from the prostate gland. Although its existence is not uncommon, the occurrence of adenocarcinoma in ectopic prostatic tissue is rare.Case presentationA 68‐year‐old man was suspected to have a nodular‐type tumor in the bladder trigone and a tumor in the prostate based on magnetic resonance imaging and cystoscopy results. Transurethral tumor resection and transrectal prostate needle biopsy revealed the coexistence of ectopic prostatic adenocarcinoma in the bladder trigone and low‐risk orthotopic prostate cancer. Four years later, the tumor evolved to intermediate‐risk prostate cancer during active surveillance, and the patient underwent prostatectomy with resection of the bladder trigone. Pathology indicated no residual ectopic prostatic tissue or adenocarcinoma at the bladder trigone.ConclusionAdenocarcinoma in ectopic prostatic tissue is very rare; however, when found, the possibility of concurrent cancer in the prostate gland should be considered.

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Multiple metastases of androgen indifferent prostate cancer in the urinary tract: two case reports and a literature review

Cited by 8 publications

References 33 publications

Brain metastasis in a patient with BRCA2-mutated treatment-related neuroendocrine prostate carcinoma and long-term response to radiotherapy and Olaparib: A case report and literature review

Brain metastasis in a patient with BRCA2-mutated treatment-related neuroendocrine prostate carcinoma and long-term response to radiotherapy and Olaparib: A case report and literature review

Aggressive variant prostate cancer with multiple subcutaneous metastases: a case report

Adenocarcinoma in ectopic prostatic tissue at the trigone of urinary bladder

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