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Durrani U, Rifai K, Arshad M, Paracha A, Deol E, Paracha M, Waheed F, Siddiqui Z, Abid A, Mustafic E, Rodriguez W, Hamilton Z. Leptomeningeal metastases in prostate cancer: A review of the current literature. Curr Urol 2024; 18:159-166. [PMID: 39219639 PMCID: PMC11337996 DOI: 10.1097/cu9.0000000000000245] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2023] [Accepted: 01/03/2024] [Indexed: 09/04/2024] Open
Abstract
Leptomeningeal metastasis/leptomeningeal carcinomatosis (LMC; terms used interchangeably) is an inflammatory complication of primary tumors that involves the spread of the disease to the meninges (specifically the arachnoid and pia maters) and spinal cord. In the United States, approximately 110,000 new cases are diagnosed each year, and the prognosis is usually poor. Complications of LMC include cognitive impairment, cranial nerve dysfunction, ischemic stroke, and mortality. The survival times of untreated and treated LMC are approximately 4-6 weeks and 2-4 months, respectively. Leptomeningeal carcinomatoses are usually metastatic cancers that spread to the central nervous system. Although lung and breast cancers have a clearly defined relationship with LMC, it remains unclear whether prostate cancer (PC) is also directly associated with LMC. To determine whether such association exists, we conducted a PubMed review of the literature on patients with PC with coexisting LMCs. Our search yielded 23 case reports of patients with preexisting PC who developed LMC. In addition, 2 retrospective cohort studies were examined. Various findings were identified in the revised cases and studies. The first 3 findings were related to the progression of the disease: patients presenting with neurological disease symptoms were in remission from PC for 7 years on average, LMCs tended to occur after other cancer diagnoses, and the disease had already rapidly progressed by the time the symptoms were present. Regarding diagnosis, the major finding was that most LMCs were detected by magnetic resonance imaging (which does not detect early dissemination), and it was suggested that single-photon emission computed tomography or positron emission tomography imaging could be used for earlier detection. Finally, in terms of treatment, the main finding was that treatment was palliative rather than curative and that prognosis remained poor despite treatment. On the basis of these results, we recommend for individuals with risk factors, such as high-grade PC and hormonal PC, to be evaluated on a case-by-case basis for increased surveillance of LMC development.
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Affiliation(s)
- Umar Durrani
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Kasem Rifai
- University of Missouri School of Medicine, Columbia, MO, USA
| | - Maha Arshad
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Awais Paracha
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Ekamjit Deol
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | | | - Fatima Waheed
- New York Institute of Technology College of Osteopathic Medicine, Old Westbury, NY, USA
| | - Zohair Siddiqui
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Ali Abid
- Saint Louis University, Saint Louis, MO, USA
| | - Esed Mustafic
- Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Wilson Rodriguez
- Department of Neurology, Saint Louis University School of Medicine, Saint Louis, MO, USA
| | - Zachary Hamilton
- Division of Urology, Department of Surgery, Saint Louis University School of Medicine, Saint Louis, MO, USA
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Kokot K, Dzierżanowski J, Krakowiak M, Fercho J, Yuser R, Kosel L, Nowiński E, Nacewicz J, Modliborska D, Szmuda T, Zieliński P. Dural metastasis of prostate carcinoma mimicking intracranial hematoma: a case report and literature review. J Surg Case Rep 2024; 2024:rjae014. [PMID: 38328455 PMCID: PMC10847406 DOI: 10.1093/jscr/rjae014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Revised: 12/26/2023] [Accepted: 01/10/2024] [Indexed: 02/09/2024] Open
Abstract
Dural metastases of prostate adenocarcinoma are an extremely rare complication and may mimic intracranial hematoma. Preoperatively diagnosis may be difficult due to similarities in symptoms and radiological appearance. We present a 65-year-old man admitted to the ED with a history of headache, nausea, vomiting, vertigo, diplopia, as well as numbness of his left lower extremity. Past medical history confirmed metastatic prostate cancer disease. After computed tomography and contrast computed tomography, the consulting radiologist diagnosed a chronic subdural hematoma. After burr hole trephination and dural opening, tumorous mass was detected. Histopathologic samples were taken. Histopathological examination was consistent with metastatic adenocarcinoma of the prostate. Although rare, dural metastases need to be included in oncological patients presenting in the ED with symptoms and radiological imaging suggesting hematoma. Both neurooncological and neurosurgical consultations are essential in order to apply the best treatment strategy.
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Affiliation(s)
- Klaudia Kokot
- Students’ Scientific Circle of Neurosurgery, Neurosurgery Department, Medical University of Gdansk, Gdansk 80-952, Poland
| | | | - Michał Krakowiak
- Neurosurgery Department, Medical University of Gdansk, Gdansk 80-952, Poland
| | - Justyna Fercho
- Neurosurgery Department, Medical University of Gdansk, Gdansk 80-952, Poland
- Cardiac Surgery Department, Medical University of Gdansk, Gdansk 80-952, Poland
| | - Rami Yuser
- Students’ Scientific Circle of Neurosurgery, Neurosurgery Department, Medical University of Gdansk, Gdansk 80-952, Poland
| | - Laura Kosel
- Students’ Scientific Circle of Neurosurgery, Neurosurgery Department, Medical University of Gdansk, Gdansk 80-952, Poland
| | - Eryk Nowiński
- Students’ Scientific Circle of Neurosurgery, Neurosurgery Department, Medical University of Gdansk, Gdansk 80-952, Poland
| | - Jacek Nacewicz
- Department of Neurosurgery, Provincial Specialist Hospital in Słupsk, Hubalczyków 1, Słupsk 76-200, Poland
| | - Dorota Modliborska
- Department of Neurosurgery, Provincial Specialist Hospital in Słupsk, Hubalczyków 1, Słupsk 76-200, Poland
| | - Tomasz Szmuda
- Neurosurgery Department, Medical University of Gdansk, Gdansk 80-952, Poland
| | - Piotr Zieliński
- Neurosurgery Department, Medical University of Gdansk, Gdansk 80-952, Poland
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Mirmoeeni S, Azari Jafari A, Shah M, Salemi F, Hashemi SZ, Seifi A. The Clinical, Diagnostic, Therapeutic, and Prognostic Characteristics of Brain Metastases in Prostate Cancer: A Systematic Review. Prostate Cancer 2022; 2022:5324600. [PMID: 36474619 PMCID: PMC9719815 DOI: 10.1155/2022/5324600] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2022] [Revised: 11/11/2022] [Accepted: 11/15/2022] [Indexed: 08/19/2023] Open
Abstract
AIM Prostate cancer (PCa) is the second most common nonskin malignancy and the second most common cause of cancer-related deaths in men. The most common site of metastasis in PCa is the axial skeleton which may lead to back pain or pathological fractures. Hematogenous spread to the brain and involvement of the central nervous system (CNS) are a rare occurrence. However, failed androgen deprivation therapy (ADT) may facilitate such a spread resulting in an advanced metastatic stage of PCa, which carries a poor prognosis. METHODS In this systematic review, we searched the PubMed, Scopus, and Web of Science online databases based on the PRISMA guideline and used all the medical subject headings (MeSH) in terms of the following search line: ("Brain Neoplasms" OR "Central Nervous System Neoplasms") and ("Prostatic Neoplasms" OR "Prostate"). Related studies were identified and reviewed. RESULTS A total of 59 eligible studies (902 patients) were included in this systematic review. In order to gain a deeper understanding, we extracted and presented the data from included articles based on clinical manifestations, diagnostic methods, therapeutic approaches, and prognostic status of PCa patients having BMs. CONCLUSION We have demonstrated the current knowledge regarding the mechanism, clinical manifestations, diagnostic methods, therapeutic approaches, and prognosis of BMs in PCa. These data shed more light on the way to help clinicians and physicians to understand, diagnose, and manage BMs in PCa patients better.
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Affiliation(s)
| | | | - Muffaqam Shah
- Deccan College of Medical Sciences, P.O. Kanchanbagh, DMRL ‘X' Road, Santhosh Nagar, Hyderabad 500058, Telangana, India
| | - Fateme Salemi
- School of Medicine, Islamic Azad University of Medical Sciences, Yazd, Iran
| | - Seyedeh Zohreh Hashemi
- Researcher at the Research Center of Tehran University of Medical Sciences, Pharmacology Department, Tehran, Iran
| | - Ali Seifi
- Department of Neurosurgery, Division of Neuro Critical Care, University of Texas Health Science Center at San Antonio School of Medicine, San Antonio, TX, USA
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Sukumaran M, Mao Q, Cantrell DR, Jahromi BS, Potts MB. Holohemispheric Prostate Carcinoma Dural Metastasis Mimicking Subdural Hematoma: Case Report and Review of the Literature. J Neurol Surg Rep 2022; 83:e23-e28. [PMID: 35273900 PMCID: PMC8904147 DOI: 10.1055/s-0042-1744127] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2019] [Accepted: 06/11/2020] [Indexed: 11/22/2022] Open
Abstract
Prostate carcinomas are the most common malignancy to metastasize to the dura. These metastases can commonly mimic subdural hematomas and may similarly present with brain compression. The optimal management and outcomes after surgical management are not well characterized. We present a case of prostate carcinoma metastatic to the dura that was initially thought to be a large isodense subdural hematoma and was treated with surgical decompression. We also review the literature regarding prostate dural metastases mimicking subdural hematomas and discuss the relevant imaging findings, treatments, and outcomes. Dural metastasis should be considered when a patient with known metastatic prostate cancer presents with imaging evidence of a subdural mass.
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Affiliation(s)
- Madhav Sukumaran
- Department of Neurological Surgery, Feinberg School of Medicine of Northwestern University, Northwestern Memorial Hospital, Chicago, Illinois, United States
| | - Qinwen Mao
- Department of Pathology, Feinberg School of Medicine of Northwestern University, Northwestern Memorial Hospital, Chicago, Illinois, United States
| | - Donald R Cantrell
- Department of Radiology, Feinberg School of Medicine of Northwestern University, Northwestern Memorial Hospital, Chicago, Illinois, United States
| | - Babak S Jahromi
- Department of Neurological Surgery, Feinberg School of Medicine of Northwestern University, Northwestern Memorial Hospital, Chicago, Illinois, United States
| | - Matthew B Potts
- Department of Neurological Surgery, Feinberg School of Medicine of Northwestern University, Northwestern Memorial Hospital, Chicago, Illinois, United States
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Chen S, Zhang J, Lu X, Cen G, Song Y, Deng X, Xie Y, Liu L, Liu Q, Huang J, Li J, Yang H, Shi S, Pan L, Liang Z. Cancer Related Subarachnoid Hemorrhage: A Multicenter Retrospective Study Using Propensity Score Matching Analysis. Front Cell Neurosci 2022; 16:813084. [PMID: 35197827 PMCID: PMC8859848 DOI: 10.3389/fncel.2022.813084] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2021] [Accepted: 01/11/2022] [Indexed: 12/22/2022] Open
Abstract
Objective To investigate the clinical features, risk factors and underlying pathogenesis of cancer related subarachnoid hemorrhage (SAH). Methods Clinical data of SAH in patients with active cancer from January 2010 to December 2020 at four centers were retrospectively reviewed. Patients with active cancer without SAH were matched to SAH patients with active cancer group. Logistic regression was applied to investigate the independent risk factors of SAH in patients with active cancer, after a 1:1 propensity score matching (PSM). A receiver operator characteristic curve was configured to calculate the optimal cut-off value of the joint predictive factor for cancer related SAH. Results A total of 82 SAH patients with active cancer and 309 patients with active cancer alone were included. Most SAH patients with cancer had poor outcomes, with 30-day mortality of 41.5%, and with 90-day mortality of 52.0%. The PSM yielded 75 pairs of study participants. Logistic regression revealed that a decrease in platelet and prolonged prothrombin time were the independent risk factors of cancer related SAH. In addition, receiver operator characteristic curve of the joint predictive factor showed the largest AUC of 0.8131, with cut-off value equaling to 11.719, with a sensitivity of 65.3% and specificity of 89.3%. Conclusion Patients with cancer related SAH often have poor outcomes. The decrease in platelet and prolonged prothrombin time are the independent risk factors of cancer related SAH, and the joint predictive factor with cutoff value equal to 11.719 should hence serve as a novel biomarker of cancer related SAH.
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Affiliation(s)
- Shijian Chen
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Jian Zhang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xianfu Lu
- Department of Neurology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Gengyu Cen
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yiting Song
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Xuhui Deng
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Yiju Xie
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Liuyu Liu
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Qianqian Liu
- Department of Neurology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Junling Huang
- Department of Neurology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Jing Li
- Department of Neurology, Affiliated Tumor Hospital of Guangxi Medical University, Nanning, China
| | - Hong Yang
- Department of Neurology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Shengliang Shi
- Department of Neurology, The Second Affiliated Hospital of Guangxi Medical University, Nanning, China
| | - Liya Pan
- Department of Neurology, Fourth Affiliated Hospital of Guangxi Medical University, Liuzhou, China
| | - Zhijian Liang
- Department of Neurology, The First Affiliated Hospital of Guangxi Medical University, Nanning, China
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Dural Metastases of Advanced Prostate Cancer Detected by 18F-Fluorocholine. Diagnostics (Basel) 2020; 10:diagnostics10060385. [PMID: 32521789 PMCID: PMC7344590 DOI: 10.3390/diagnostics10060385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2020] [Revised: 06/04/2020] [Accepted: 06/05/2020] [Indexed: 11/17/2022] Open
Abstract
Prostate cancer with extensive dural metastases is very rare, with only few cases described in the literature. We report one such case of a 74-year-old man with advanced prostate cancer, and in relatively good clinical condition. The patient returned with complaints of headache and diplopia. Fluorocholine (18F) chloride (18F-FCH) is an analog of choline in which a hydrogen atom has been replaced by fluorine (18F). After crossing the cell membrane by a carrier-mediated mechanism, choline is phosphorylated by choline kinase to produce phosphorylcholine. 18F-FCH positron emission tomography–computed tomography (PET/CT) is widely used to stage and restage patients affected by prostate cancer with good sensitivity. 18F-FCH PET/CT showed disease progression with the onset of multiple skull lesions. Numerous suspicious dural hypermetabolic lesions indicating neoplastic involvement were detected along the fronto-parietal convexities, in the left fronto-orbital region and right lateral wall of the orbit, concerning for metastases in these regions. A contrast-enhanced computed tomography (CECT) scan was performed which showed corresponding enhancing tissue which correlated with the PET findings. The final imaging diagnosis was osteo-dural metastases from prostate cancer associated with poor outcome. Awareness of this pattern of metastases may be of clinical relevance in order to avoid unnecessary invasive diagnostic procedures in groups of patients with a dismal prognosis.
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Tan LQ, Loh DDL, Qiu L, Ng YP, Hwang PYK. When hoofbeats mean zebras not horses: Tumour mimics of subdural haematoma - Case series and literature review. J Clin Neurosci 2019; 67:244-248. [PMID: 31279699 DOI: 10.1016/j.jocn.2019.06.035] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 05/22/2019] [Accepted: 06/21/2019] [Indexed: 11/18/2022]
Abstract
Chronic subdural haematomas are common neurosurgical conditions, especially in the elderly patients, with straightforward surgical treatments. However, infrequently, tumours are misdiagnosed as subdural haematoma on initial brain CT scans and are only discovered intraoperatively. In this case series, we presented 3 different patients who were initially thought to have subdural haematoma but later found to be tumour mimics of different histological origin. A literature review and discussion of recently published tumour mimics of subdural haematoma was also performed. It is recommended that in patients with suggestive oncological or haematological history, or unusual characteristics on the plain CT brain, a high level of suspicion of tumour mimics needs to be maintained. A full workup with contrast-enhanced magnetic resonance imaging is important to distinguish from subdural haematoma, as the treatment paradigms and prognoses are vastly different.
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Affiliation(s)
| | | | - Liming Qiu
- Department of Neurosurgery, National Neuroscience Institute, Singapore.
| | - Yew Poh Ng
- Department of Neurosurgery, National Neuroscience Institute, Singapore
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