Kobayashi Masaaki, Sasagawa Yasuo, Nakada Satoko, Kohda Yukihiko, Nakada Mitsutoshi
Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University.
Department of Pathology, Kanazawa University Hospital.
Surg Neurol Int. 2022 Sep 9;13:407. doi: 10.25259/SNI_257_2022. eCollection 2022.
Prostate carcinoma rarely metastasizes to the central nervous system. However, when it does, a dural lesion is a common and possible misdiagnosis of meningioma. Here, we describe a case of a 77-year-old man with dural metastasis from prostate carcinoma of the tuberculum sellae.
The patient was diagnosed with prostate carcinoma 7 years previously and was well-controlled by hormone therapy. He was incidentally found to have a suprasellar tumor and underwent endoscopic endonasal transsphenoidal surgery because of rapid tumor growth and worsening visual impairment. Since his serum prostate-specific antigen (PSA) level was within the normal range, malignant meningioma was suspected based on the magnetic resonance imaging (MRI) and the course. However, the pathological findings revealed dural metastasis from prostate carcinoma. He received radiation therapy, and the tumor disappeared on MRI. His visual impairment improved without recurrence. This case report highlights that dural metastasis of the tuberculum sellae arose despite the patient's PSA level being within the normal range, and a single metastasis to the dura was found.
In patients with a history of prostate carcinoma or older men, careful follow-up considering the possibility of metastasis is required when a dural lesion is found.
前列腺癌很少转移至中枢神经系统。然而,一旦发生转移,硬脑膜病变较为常见,且可能被误诊为脑膜瘤。在此,我们报告一例77岁男性,其鞍结节处发生前列腺癌硬脑膜转移。
该患者7年前被诊断为前列腺癌,通过激素治疗病情得到良好控制。他偶然发现鞍上有肿瘤,因肿瘤迅速生长且视力损害加重,接受了鼻内镜经蝶窦手术。由于其血清前列腺特异性抗原(PSA)水平在正常范围内,根据磁共振成像(MRI)及病程怀疑为恶性脑膜瘤。然而,病理结果显示为前列腺癌硬脑膜转移。他接受了放射治疗,MRI显示肿瘤消失。其视力损害改善,未复发。本病例报告强调,尽管患者PSA水平在正常范围内,但仍发生了鞍结节硬脑膜转移,且发现为硬脑膜单一转移。
对于有前列腺癌病史的患者或老年男性,发现硬脑膜病变时,需考虑转移可能性进行仔细随访。