Balbino Marina, Montatore Manuela, Masino Federica, Gifuni Rossella, Muscatella Gianmichele, Sciaqua Alessio, Guglielmi Giuseppe
Department of Clinical and Experimental Medicine, Foggia University School of Medicine, Viale L. Pinto 1, 71122 Foggia, Italy.
Radiology Unit, "Dimiccoli" Hospital, Viale Ippocrate 15, 70051, Barletta, Italy.
Radiol Case Rep. 2025 Aug 27;20(11):5715-5718. doi: 10.1016/j.radcr.2025.08.012. eCollection 2025 Nov.
We report a rare case of breast and axillary metastases in a 75-year-old man diagnosed with prostate carcinoma. Initially, the patient presented with lower urinary tract symptoms (LUTS) and elevated prostate-specific antigen (PSA) levels. Prostate cancer was confirmed by biopsy and treated with androgen deprivation therapy (ADT) and radiotherapy. At the time the breast mass was detected, the patient was already undergoing ADT. Two years and 2 months after diagnosis, he developed a palpable mass in the left breast. Imaging and ultrasound-guided biopsy revealed metastatic prostate adenocarcinoma involving the breast and ipsilateral axillary lymph nodes, initially suspected as primary breast cancer or gynecomastia secondary to hormonal therapy. Systemic ADT was reinitiated, and palliative radiotherapy was administered to the breast. The patient responded favorably, with a significant PSA reduction and disease stabilization. This case emphasizes the importance of recognizing atypical metastatic sites in prostate cancer and the critical role of combined imaging and histopathological evaluation. Further research is needed to elucidate the mechanisms and clinical implications of such rare metastatic patterns.
我们报告了一例75岁男性前列腺癌伴乳腺及腋窝转移的罕见病例。最初，患者出现下尿路症状（LUTS）且前列腺特异性抗原（PSA）水平升高。经活检确诊为前列腺癌，并接受了雄激素剥夺治疗（ADT）和放疗。在检测到乳腺肿块时，患者已在接受ADT治疗。诊断后两年零两个月，他左侧乳房出现可触及肿块。影像学检查和超声引导下活检显示为转移性前列腺腺癌，累及乳腺及同侧腋窝淋巴结，最初怀疑为原发性乳腺癌或激素治疗继发的男性乳房发育症。重新开始全身ADT治疗，并对乳房进行姑息性放疗。患者反应良好，PSA显著降低，病情稳定。该病例强调了认识前列腺癌非典型转移部位的重要性以及联合影像学和组织病理学评估的关键作用。需要进一步研究以阐明这种罕见转移模式的机制及临床意义。
