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同时性胸椎转移性黑色素瘤与既往存在的前列腺腺癌:1例独特病例报告及文献复习

Simultaneous Thoracic Spine Metastatic Melanoma and Pre-existing Prostate Adenocarcinoma: A Unique Case Presentation and Literature Review.

作者信息

Venkata Srikanth A, Hakobyan Narek, Yadav Ruchi, Pokhrel Akriti, Jamal Fares, Oudit Omar, Boris Avezbakiyev, Kay Arthur

机构信息

Neurology, Brookdale University Hospital Medical Center, Brooklyn, USA.

Internal Medicine, Brookdale University Hospital Medical Center, Brooklyn, USA.

出版信息

Cureus. 2023 Aug 13;15(8):e43429. doi: 10.7759/cureus.43429. eCollection 2023 Aug.

Abstract

In melanoma patients, distant metastases frequently manifest in the skin, lung, brain, liver, bone, and intestine. Notably, bone metastasis predominantly occurs within the axial skeleton, with the lumbar and thoracic spines being the most affected regions. Conversely, prostate cancer often disseminates to the bone, lung, liver, pleura, and adrenal glands. The spinal column, particularly the lumbar region, frequently harbors metastases in prostate cancer cases. Given the proximity of axial lesions to the spinal cord, patients commonly experience pain, weakness, and urinary dysfunction. This article presents a compelling case report of a patient initially diagnosed with metastatic prostate cancer, who later exhibited a metastatic lesion in the thoracic spine, subsequently identified as originating from acral melanoma on the plantar surface of the right foot. Histopathological examination confirmed the presence of acral melanoma in both the spine and the right foot. The patient received comprehensive treatment for advanced melanoma from a multidisciplinary team comprising medical and radiation oncologists. Considering the overlapping pathophysiology of prostate cancer and melanoma, simultaneous screening for both diseases in cases where one is detected could yield significant benefits, including enhanced morbidity and mortality outcomes and the facilitation of early detection for secondary malignancies.

摘要

在黑色素瘤患者中,远处转移常出现在皮肤、肺、脑、肝、骨和肠道。值得注意的是,骨转移主要发生在中轴骨骼,腰椎和胸椎是受影响最严重的区域。相反,前列腺癌常扩散至骨、肺、肝、胸膜和肾上腺。在前列腺癌病例中,脊柱,尤其是腰椎区域,经常存在转移灶。鉴于中轴病变靠近脊髓,患者通常会经历疼痛、虚弱和排尿功能障碍。本文介绍了一例令人瞩目的病例报告,一名患者最初被诊断为转移性前列腺癌,后来在胸椎出现转移性病变,随后被确定源自右脚足底的肢端黑色素瘤。组织病理学检查证实脊柱和右脚均存在肢端黑色素瘤。该患者接受了由医学肿瘤学家和放射肿瘤学家组成的多学科团队针对晚期黑色素瘤的综合治疗。考虑到前列腺癌和黑色素瘤重叠的病理生理学,在检测到其中一种疾病的情况下同时对两种疾病进行筛查可能会带来显著益处,包括改善发病率和死亡率结果以及便于早期发现继发性恶性肿瘤。

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