Hafiz Asim, Karim Muneeb Uddin, Qureshi Bilal M, Jabbar Adnan A, Ahmad Zubair
Radiation Oncology, Aga Khan University, Karachi, PAK.
Oncology, Aga Khan University, Karachi, PAK.
Cureus. 2019 Jun 2;11(6):e4804. doi: 10.7759/cureus.4804.
Cerebral metastasis as an initial clinical presentation of prostate carcinoma is extremely rare. Usually, patients have widespread metastasis in the body before presenting with brain metastasis. In the absence of extensive metastasis, especially without bony metastasis, only brain metastasis is an unusual presentation of the disease. We report a case of a 59-years-old patient who presented with a lack of concentration and decreased vision. Magnetic resonance imaging (MRI) of the brain revealed a large right parietal-occipital space-occupying lesion. He underwent surgery and the pathological diagnosis of the tumor turned out to be metastatic prostate carcinoma. Further evaluation by a whole-body computed tomography (CT) scan revealed an enlarged prostate with no other metastatic deposit and a mildly raised level of prostate-specific antigen (PSA). It was possible for us to provide this patient with multi-modality treatment with the help of multidisciplinary tumor board meetings. Further studies addressing the biological as well as clinical characteristics of prostate carcinoma with this rare metastatic presentation will help us to define prognostic factors and therapeutic intervention and will help us to understand the basis of this unique presentation without bone metastasis.
脑转移作为前列腺癌的初始临床表现极为罕见。通常，患者在出现脑转移之前身体已有广泛转移。在没有广泛转移，尤其是没有骨转移的情况下，仅出现脑转移是该疾病的一种不寻常表现。我们报告一例59岁患者，其表现为注意力不集中和视力下降。脑部磁共振成像（MRI）显示右侧顶枕叶有一个大的占位性病变。他接受了手术，肿瘤的病理诊断为转移性前列腺癌。全身计算机断层扫描（CT）进一步评估显示前列腺肿大，无其他转移灶，前列腺特异性抗原（PSA）水平轻度升高。借助多学科肿瘤委员会会议，我们能够为该患者提供多模式治疗。针对具有这种罕见转移表现的前列腺癌的生物学及临床特征进行的进一步研究，将有助于我们确定预后因素和治疗干预措施，并有助于我们理解这种无骨转移的独特表现的基础。
