Ibrahim Sufyan, Reddy Vyjayanth, Menon Girish
Department of Neurosurgery, Kasturba Medical College, Manipal Academy of Higher Education (MAHE), Manipal, Karnataka, India.
J Neurosci Rural Pract. 2022 May 25;13(3):558-560. doi: 10.1055/s-0042-1745819. eCollection 2022 Jul.
Intracranial metastases from prostate carcinoma are uncommon and usually manifest as dural secondaries in the supratentorial compartment. We present an unusual case of intra-parenchymal posterior fossa prostatic metastasis in a 61-year-old gentleman and discuss the diagnostic and management challenges involved. A 61-year-old hypertensive, diabetic man presented with gait unsteadiness for 1-month duration and no other neurological deficits. He had previously undergone bilateral orchiectomy for prostate carcinoma with multiple osseous metastases. Magnetic resonance imaging showed a well-defined lobulated, intraventricular, peripherally enhancing lesion in the fourth ventricle with obstructive hydrocephalus. He underwent sub-occipital craniectomy and decompression, and histological examination was consistent with metastatic prostate adenocarcinoma. Although cerebellar secondaries are atypical, a suspicion of metastasis should be upheld in all patients with the history of prostate carcinoma, regardless of their location and radiological characteristics of the intracranial lesion.
前列腺癌的颅内转移并不常见，通常表现为幕上间隙的硬脑膜继发性转移。我们报告了一例61岁男性患者罕见的脑实质内后颅窝前列腺转移病例，并讨论其中涉及的诊断和管理挑战。一名61岁的高血压、糖尿病男性患者，出现步态不稳1个月，无其他神经功能缺损。他之前因前列腺癌伴多发骨转移接受了双侧睾丸切除术。磁共振成像显示第四脑室内有一个边界清晰的分叶状、脑室内、周边强化的病变，伴有梗阻性脑积水。他接受了枕下开颅减压术，组织学检查结果与转移性前列腺腺癌一致。尽管小脑继发性转移不典型，但对于所有有前列腺癌病史的患者，无论颅内病变的位置和影像学特征如何，都应怀疑有转移。
