Prostate Cancer Metastatic to the Peritoneum: A Road Less Traveled by a Common Malignancy

Tareen, Serene; Rodríguez, Juan Luis Rodríguez; Wu, Phillis

doi:10.7759/cureus.4222

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…Ascites occurred one week after aborted prostatectomy in one case, though imaging suggested peritoneal deposits before this. 17 There was a documented response of ascites in 14 cases (43.8%), remaining stable in two (6.3%), diminishing in five (14.3%), and resolving in six (18.8%) with remission. Ascites diminished at least transiently in two cases of disease progression, including our own.…”

Section: Resultsmentioning

confidence: 87%

Case Report: A rare presentation of prostate cancer with peritoneal carcinomatosis and malignant ascites complicated by tumor lysis syndrome

Venkateswaran

Elzein²,

Sulpizio³

et al. 2022

F1000Res

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Background: Only 32 cases of prostate cancer with peritoneal carcinomatosis and ascites have currently been reported in the literature. We present the first reported case of prostate cancer with peritoneal carcinomatosis and malignant ascites whose treatment was complicated by tumor lysis syndrome along with a literature review evaluating similar cases. Case: We present a rare case of a 78-year-old retired Caucasian male with recurrent metastatic prostate cancer and malignant ascites. He had previously received definitive radiotherapy for localized prostate cancer but presented with bilateral hydronephrosis and right-sided bladder wall thickening 10 years later. He had imaging evidence of locoregional recurrence with elevated prostate specific antigen (PSA) and was initiated on combined androgen blockade with intramuscular leuprolide and oral bicalutamide. After being transferred to Scripps Clinic, he was found to have a solitary right upper lobe pulmonary lesion for which he completed stereotactic body radiation therapy. Then, 10 months later, he developed new onset malignant ascites and was treated with two cycles of intravenous docetaxel. Treatment resulted in improvement in his ascites and reduction in PSA. Unfortunately, his course was complicated by tumor lysis syndrome, encephalopathy, Escherichia coli bacteremia, and a fatal saddle pulmonary embolism. Conclusions: (1) Occurrence of ascites in prostate cancer patients is associated with worse prognosis than non-ascitic variants. (2) More common etiologies of ascites must be evaluated for. (3) Ascitic fluid prostate specific antigen (PSA) measurement may aid in diagnosis of malignant ascites in cases with diagnostic uncertainty. (4) Patients with advanced disease may benefit from combined hormonal and cytotoxic therapies. (5) Awareness of the occurrence of tumor lysis syndrome (TLS) in patients treated for prostate cancer can help identify patients in whom prophylaxis would be beneficial.

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Section: Resultsmentioning

confidence: 87%

Case Report: A rare presentation of prostate cancer with peritoneal carcinomatosis and malignant ascites complicated by tumor lysis syndrome

Venkateswaran

Elzein²,

Sulpizio³

et al. 2022

F1000Res

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Case report: Robotically visualized and biopsy-confirmed peritoneal carcinomatosis as initial identification of metastatic prostate adenocarcinoma in a patient with a history of prostatic urethral lift

Khan,

Myers,

Bowar

et al. 2024

Front. Oncol.

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BackgroundPeritoneal carcinomatosis is a particularly rare presentation of prostate cancer. Here we report a rare clinical case of surgically identified peritoneal carcinomatosis at the time of a planned robotic prostatectomy in a patient with a history of prostatic urethral lift procedure.Case presentationA 72-year-old man, with a history of urinary retention managed with tamsulosin, presented to his local urologist. Prostatic urethral lift procedures were performed for symptom management. After a definitive uptrend in his prostate-specific antigen (PSA) values, a biopsy was obtained, which demonstrated prostate adenocarcinoma. On presurgical multidisciplinary review, it was presumed that he had very high-risk localized prostate cancer. However, upon initiation of robotically assisted laparoscopic radical prostatectomy (RALP), he was noted to have numerous punctate white plaques on the peritoneum; biopsy of these lesions confirmed metastatic disease—for which the patient was starting on triple therapy per the PEACE-1 trial. The PSA level responded appropriately, decreasing from 16.8 to 0.08. Genetic testing was performed and returned negative for any clinically significant mutations.ConclusionOur patient, diagnosed with peritoneal carcinomatosis during a planned RALP, highlights the importance of vigilant laparoscopic exam prior to this prostatectomy. Multidisciplinary discussion is crucial for individualized and optimal treatment planning.

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Prostate Cancer Metastatic to the Peritoneum: A Road Less Traveled by a Common Malignancy

Cited by 2 publications

References 9 publications

Case Report: A rare presentation of prostate cancer with peritoneal carcinomatosis and malignant ascites complicated by tumor lysis syndrome

Case Report: A rare presentation of prostate cancer with peritoneal carcinomatosis and malignant ascites complicated by tumor lysis syndrome

Case report: Robotically visualized and biopsy-confirmed peritoneal carcinomatosis as initial identification of metastatic prostate adenocarcinoma in a patient with a history of prostatic urethral lift

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