Porto Carl, Abdulrazeq Hael, Sastry Rahul, Chang Allison, Riccelli Tori, Punsoni Michael, Sampath Prakash
Warren Alpert School of Medicine, Brown University, Providence, Rhode Island.
Department of Neurosurgery, Rhode Island Hospital, Warren Alpert School of Medicine, Brown University, Providence, Rhode Island.
J Neurosurg Case Lessons. 2025 Apr 28;9(17). doi: 10.3171/CASE24705.
Prostate carcinoma, despite being the most common cancer in men, rarely metastasizes to the brain. Small cell prostate carcinoma represents a small percentage of cases, and few cases of intracranial small cell prostate metastases have been reported. Here, the authors report a unique case of an operatively managed extra-axial small cell prostate carcinoma.
A 63-year-old male with a history of small cell prostate carcinoma presented asymptomatically with abnormal brain imaging. MRI and prostate-specific membrane antigen PET imaging revealed a 2.8-cm mass in the right frontal lobe and a smaller right thalamic lesion. The mass was resected through a frontotemporal approach, and gross-total resection was achieved. The patient will receive adjuvant chemotherapy and radiation therapy.
Intracranial prostate metastases tend to be slow growing and can have indolent clinical courses, although they can become symptomatic at large sizes. Small cell prostate metastases are more aggressive than adenocarcinoma and have a higher propensity for dural rather than intraparenchymal localization. The standard of care, which is derived from the management of metastatic prostate adenocarcinoma, involves maximal safe resection and adjuvant chemotherapy and radiation therapy, although intracranial small cell prostate metastases are a poor prognosticator. https://thejns.org/doi/10.3171/CASE24705.
前列腺癌虽是男性最常见的癌症，但很少转移至脑部。小细胞前列腺癌占病例的比例较小，颅内小细胞前列腺转移的病例报道较少。在此，作者报告一例经手术治疗的轴外小细胞前列腺癌的独特病例。
一名有小细胞前列腺癌病史的63岁男性，脑部影像检查异常但无症状。磁共振成像（MRI）和前列腺特异性膜抗原正电子发射断层扫描（PET）成像显示右额叶有一个2.8厘米的肿块以及右侧丘脑有一个较小的病变。通过额颞入路切除了肿块，实现了大体全切。患者将接受辅助化疗和放疗。
颅内前列腺转移瘤往往生长缓慢，临床病程可能较为隐匿，尽管体积较大时可能出现症状。小细胞前列腺转移瘤比腺癌更具侵袭性，且更倾向于硬膜而非脑实质内定位。源自转移性前列腺腺癌治疗方法的标准治疗方案包括最大程度的安全切除以及辅助化疗和放疗，尽管颅内小细胞前列腺转移瘤预后较差。https://thejns.org/doi/10.3171/CASE24705
