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Brain Metastasis from Prostate Small Cell Carcinoma: Not to be Neglected

Published online by Cambridge University Press:  02 December 2014

Corrie E. Erasmus ,
Wim I.M. Verhagen ,
Carla A.P. Wauters  and
Erik J. van Lindert
Corrie E. Erasmus
Affiliation:
Department of Neurosurgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands Department of Neurology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
Wim I.M. Verhagen
Affiliation:
Department of Neurology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
Carla A.P. Wauters
Affiliation:
Department of Pathology, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
Erik J. van Lindert
Affiliation:
Department of Neurosurgery, Canisius Wilhelmina Hospital, Nijmegen, The Netherlands
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Abstract

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Background:

Symptomatic brain metastases from prostatic carcinoma are rare (0.05% to 0.5%).

Case report:

A 70-year-old man presented with a homonymous hemianopsia due to brain metastatic prostatic carcinoma shortly before becoming symptomatic of prostatic disease. CT and MRI of the brain showed a tumour deep in the right hemisphere near the thalamus and involving the optic radiation.

Results:

Routine haematological and biochemical tests were normal. The prostate specific antigen level was low on two separate occasions. The prostatic and brain tumours showed identical appearances, namely of a poorly differentiated adenocarcinoma with neuroendocrine differentiation (small cell carcinoma).

Conclusion:

A literature review suggests that small cell carcinoma of the prostate is more likely to spread to the brain compared to adenocarcinoma and that brain metastases indicate a poor prognosis. The prostate gland should be remembered as a possible cause of brain metastases and that a normal serum prostate specific antigen does not exclude this diagnosis.

Résumé:

RÉSUMÉ:Introduction:

Les métastases cérébrales symptomatiques d’un carcinome de la prostate sont rares (0,05% à 0,5%).

Présentation de cas:

Un homme âgé de 70 ans a consulté pour une hémianopsie homonyme due à un carcinome prostatique ayant métastasié au cerveau, peu avant de présenter des symptômes de sa pathologie de la prostate. La tomodensitométrie et l’imagerie par résonance magnétique du cerveau ont montré une tumeur située profondément dans l’hémisphère droit près du thalamus et impliquant la radiation optique.

Résultats:

Les épreuves hématologiques et biochimiques de routine étaient normales. Le taux de l’antigène prostatique spécifique (APS) mesuré à deux reprises était bas. Les tumeurs prostatique et cérébrale avaient une apparence identique, soit celle d’un adénocarcinome peu différencié comportant une différenciation neuroendocrinienne (carcinome à petites cellules, CPC).

Conclusion:

Une revue de la littérature suggère que le CPC de la prostate est plus susceptible de métastasier au cerveau que l’adénocarcinome, et que des métastases cérébrales indiquent un pronostic défavorable. On devrait penser à la prostate comme site possible d’origine de métastases cérébrales et un APS normal n’exclut pas ce diagnostic.

Type
Case Report
Information
Canadian Journal of Neurological Sciences , Volume 29 , Issue 4 , November 2002 , pp. 375 - 377
Copyright
Copyright © The Canadian Journal of Neurological 2002

References

1. Fervenza, F, Wolanskyj, AP, Eklund, HE, Richardson, RL. Brain metastasis: an unusual complication from prostatic adenocarcinoma. Mayo Clin Proc 2000; 75:79–82.CrossRefGoogle ScholarPubMed
2. Freedy, RM, Miller, KD Jr. Small cell carcinoma of prostate: metastases to the brain as shown by CT and MRI with pathologic correlation. AJNR 1990;11:947–948.Google Scholar
3. Leibman, BD, Dillioglugil, O, Wheeler, TM, Scardino, PT. Distant metastasis after radical prostatectomy in patients without an elevated serum prostate specific antigen level. Cancer 1995; 76:2530–2534.Google Scholar
4. Rubenstein, JH, Katin, MJ, Mangano, MM, et al. Small cell anaplastic carcinoma of the prostate: seven new cases, review of the literature, and discussion of a therapeutic strategy. Am J Clin Oncol 1997;20:376–380.CrossRefGoogle ScholarPubMed
5. Sutton, MA, Watkins, HL, Green, LK, Kadmon, D. Intracranial metastases as the first manifestation of prostate cancer. Urology 1996; 48:789–793.CrossRefGoogle ScholarPubMed
6. Chung, TS, Thannikkary, C. Carcinoma of the prostate with brain metastasis. J Surg Oncol 1986; 33:103–105.CrossRefGoogle ScholarPubMed
7. Schwartz, LH, LaTrenta, LR, Bonaccio, E, et al. Small cell and anaplastic prostate cancer; correlation between CT findings and prostate-specific antigen level. Radiology 1998;208:735–738.Google Scholar
8. Ercole, CJ, Lange, PH, Mathisen, M, et al. Prostate specific antigen and prostatic acid phosphatase in monitoring and staging of patients with prostatic cancer. J Urol 1987; 138:1181–1184.Google Scholar
9. Aygun, C. Small cell carcinoma of the prostate: a case report and review of the literature. Md Med J 1997; 46:353–356.Google Scholar
10. Smith, JA Jr, Crawford, ED, Lange, PH, et al. PSA correlation with response and survival in advanced carcinoma of the prostate. J Urol 1991; 145:384a.Google Scholar
11. Rivas Alonso, A, Gomez Dorronsoro, M, Valenti Ponsa, C. Carcinoma de celula pequena de prostata con metastasis cerebral. Actas Urol Esp 1996;20:582–585.Google Scholar
12. McCutcheon, IE, Eng, DY, Logothetis, CJ. Brain metastasis from prostate carcinoma. Antemortem recognition and outcome after treatment. Cancer 1999; 86:2301–2311.3.0.CO;2-D>CrossRefGoogle ScholarPubMed
13. Catane, R, Kaufman, J, West, C, et al. Brain metastasis from prostatic carcinoma. Cancer 1976; 38:2583–2587.3.0.CO;2-D>CrossRefGoogle ScholarPubMed
14. Zachariah, B, Casey, L, Zachariah, SB, Baekey, P, Greenberg, HM. Case report: brain metastasis from primary small cell carcinoma of the prostate. Am J Med Sci 1994; 308:177–179.CrossRefGoogle ScholarPubMed
15. Saitoh, H, Hida, M, Shimbo, T, et al. Metastatic patterns of prostatic cancer. Correlation between sites and number of organs involved. Cancer 1984; 54:3078–3084.Google Scholar
16. Lynes, WL, Bostwick, DG, Freiha, FS, Stamey, TA. Parenchymal brain metastases from adenocarcinoma of prostate. Urology 1986; 28:280–287.Google Scholar
17. Gleason, DF. Histologic grading and clinical staging of prostatic carcinoma. In: Tannenbaum, M, (Ed.) Urologic pathology: the prostate. Philadelphia: Lea & Febiger, 1977:171–198.Google Scholar
18. Lynch, DF, Hassen, W, Clements, MA, Schellhammer, PF, Wright, GL. Serum levels of endothelial and neural cell adhesion molecules in prostate cancer. Prostate 1997;32:214–220.Google Scholar
19. Hashine, K, Nakatsuji, H, Karashima, T, et al. Small cell carcinoma of the prostate: a case report. Hinyokika Kiyo 1998;44:607–610.Google Scholar
20. Partin, AW, Carter, HB, Chan, DW, et al. Prostate specific antigen in staging of localized prostate cancer: influence of tumour differentiation, tumour volume and benign hyperplasia. J Urol 1990;143:747–752.CrossRefGoogle ScholarPubMed
21. Leo, ME, Bilhartz, DL, Bergstralh, EJ, Oesterling, JE. Prostate specific antigen in hormonally treated stage D2 prostate cancer: is it always an accurate indicator of disease status? J Urol 1991; 145:802–806.Google Scholar
22. Blunt, DM, Sansom, HE, King, DM. Imaging of small cell carcinoma of the male urogenital tract. Clin Radiol 1996;51:724–727.Google Scholar
23. Aihara, M, Lebovitz, RM, Wheeler, TM, et al. Prostate specific antigen and Gleason grade: an immunohistochemical study of prostate cancer. J Urol 1994; 151:1558–1564.Google Scholar