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Morozov A, Chuvalov L, Taratkin M, Enikeev M, Rapoport L, Singla N, Barret E, Poddubskaya E, Borodina M, Salomon G, Rivas JG, Enikeev D. A systematic review of cytoreductive prostatectomy outcomes and complications in oligometastatic disease. Asian J Urol 2024; 11:208-220. [PMID: 38680575 PMCID: PMC11053306 DOI: 10.1016/j.ajur.2022.03.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 02/07/2022] [Accepted: 03/07/2022] [Indexed: 12/03/2022] Open
Abstract
Objective To analyze outcomes and complications of cytoreductive prostatectomy (CRP) for oligometastatic prostate cancer (PCa) in order to elucidate its role in this space. Methods We performed a systematic literature search using three databases (Medline, Scopus, and Web of Science). The primary endpoints were oncologic outcomes. The secondary endpoints were complication rates and functional results. Results In all studies, overall survival was better or at least comparable variable in the groups with CRP compared to no local treatment. The greatest benefit from CRP in 5-year overall survival in one study was 67.4% for CRP versus 22.5% for no local treatment. Cancer-specific survival (CSS) showed the same trend. Several authors found significant benefits from CSS in the CRP group: from 79% vs. 46% to 100% vs. 61%. CRP was a predictor of better CSS (hazard ratio 0.264, p=0.004). Positive surgical margin rates differed widely from 28.6% to 100.0%. Urinary continence in CRP versus RP for localized PCa was significantly lower (57.4% vs. 90.8%, p<0.0001). Severe incontinence occurred seldom (2.5%-18.6%). Total complication rates after CRP differed widely, from 7.0% to 43.6%. Rates of grades 1 and 2 events prevailed. Patients on ADT alone also showed a considerable number of complications varying from 5.9% to 57.7%. Conclusion CRP improves medium-term cancer control in patients with oligometastatic PCa. The morbidity and complication rates of this surgery are comparable with other approaches, but postoperative incontinence rate is higher compared with RP for localized disease.
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Affiliation(s)
- Andrey Morozov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Leonid Chuvalov
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Mark Taratkin
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
- Young Academic Urologists, EAU, the Netherlands
| | - Mikhail Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Leonid Rapoport
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
| | - Nirmish Singla
- Department of Urology, James Buchanan Brady Urological Institute, The Johns Hopkins University School of Medicine, Baltimore, USA
| | - Eric Barret
- Department of Urology, Institut Mutualiste Montsouris, Paris, France
| | | | - Maria Borodina
- Hertsen Moscow Oncology Research Institute, Moscow, Russia
| | - Georg Salomon
- Martini Clinic, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Juan Gomez Rivas
- Department of Urology, Clinico San Carlos University Hospital, Madrid, Spain
| | - Dmitry Enikeev
- Institute for Urology and Reproductive Health, Sechenov University, Moscow, Russia
- Department of Urology, Medical University of Vienna, Vienna, Austria
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Abufaraj M, Ramadan R, Alkhatib A. Paraneoplastic Syndromes in Neuroendocrine Prostate Cancer: A Systematic Review. Curr Oncol 2024; 31:1618-1632. [PMID: 38534956 PMCID: PMC10969281 DOI: 10.3390/curroncol31030123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2024] [Revised: 02/24/2024] [Accepted: 02/26/2024] [Indexed: 05/26/2024] Open
Abstract
Neuroendocrine prostate cancer (NEPC) is a rare subtype of prostate cancer (PCa) that usually results in poor clinical outcomes and may be accompanied by paraneoplastic syndromes (PNS). NEPC is becoming more frequent. It can initially manifest as PNS, complicating diagnosis. Therefore, we reviewed the literature on the different PNS associated with NEPC. We systematically reviewed English-language articles from January 2017 to September 2023, identifying 17 studies meeting PRISMA guidelines for NEPC and associated PNS. A total of 17 articles were included in the review. Among these, Cushing's Syndrome (CS) due to ectopic Adrenocorticotropic hormone (ACTH) secretion was the most commonly reported PNS. Other PNS included syndrome of inappropriate Anti-Diuretic Hormone secretion (SIADH), Anti-Hu-mediated chronic intestinal pseudo-obstruction (CIPO), limbic encephalitis, Evans Syndrome, hypercalcemia, dermatomyositis, and polycythemia. Many patients had a history of prostate adenocarcinoma treated with androgen deprivation therapy (ADT) before neuroendocrine features developed. The mean age was 65.5 years, with a maximum survival of 9 months post-diagnosis. NEPC is becoming an increasingly more common subtype of PCa that can result in various PNS. This makes the diagnosis and treatment of NEPC challenging. Further research is crucial to understanding these syndromes and developing standardized, targeted treatments to improve patient survival.
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Affiliation(s)
- Mohammad Abufaraj
- Division of Urology, Department of Special Surgery, The University of Jordan, Amman 11942, Jordan
| | - Raghad Ramadan
- School of Medicine, The University of Jordan, Amman 11942, Jordan
| | - Amro Alkhatib
- School of Medicine, The University of Jordan, Amman 11942, Jordan
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3
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Moata H, Hali F, Zafad S, Jouhadi H, Chiheb S. Recalcitrant Paraneoplastic Pemphigus Associated With Prostate Adenocarcinoma: Spectacular Evolution Under Androgen Deprivation. Cureus 2023; 15:e43585. [PMID: 37719500 PMCID: PMC10503779 DOI: 10.7759/cureus.43585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/16/2023] [Indexed: 09/19/2023] Open
Abstract
Paraneoplastic pemphigus (PNP) is a rare, autoimmune, blistering condition defined by severe stomatitis, polymorphous cutaneous eruptions, and underlying neoplasms. PNP associated with solid cancer is extremely rare. An association with prostate adenocarcinoma remains exceptional. We describe a 69-year-old patient with recalcitrant PNP associated with prostate adenocarcinoma showing spectacular response immediately after associating hormonotherapy with conventional immunosuppressive drugs.
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Affiliation(s)
- Hajar Moata
- Department of Dermatology and Venerology, Ibn Rochd University Hospital, Casablanca, MAR
| | - Fouzia Hali
- Department of Dermatology and Venerology, Ibn Rochd University Hospital, Casablanca, MAR
| | - Safia Zafad
- Department of Oncology and Radiotherapy, Mohammed VI Cancer Treatment Center, Ibn Rochd University Hospital, Casablanca, MAR
| | - Hassan Jouhadi
- Department of Oncology and Radiotherapy, Mohammed VI Cancer Treatment Center, Ibn Rochd University Hospital, Casablanca, MAR
| | - Soumiya Chiheb
- Department of Dermatology and Venerology, Ibn Rochd University Hospital, Casablanca, MAR
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4
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Tatachar S, John R, Hephzibah J, Kumar S, Paul TV, Cherian KE. Tumour-Induced Osteomalacia in Metastatic Prostate Carcinoma. Indian J Endocrinol Metab 2023; 27:368-369. [PMID: 37867990 PMCID: PMC10586558 DOI: 10.4103/ijem.ijem_125_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 04/12/2023] [Accepted: 04/26/2023] [Indexed: 10/24/2023] Open
Affiliation(s)
- Sreevatsa Tatachar
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Rebecca John
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Julie Hephzibah
- Department of Nuclear Medicine, Christian Medical College, Vellore, Tamil Nadu, India
| | - Santhosh Kumar
- Department of Urology, Christian Medical College, Vellore, Tamil Nadu, India
| | - Thomas V. Paul
- Department of Endocrinology, Christian Medical College, Vellore, Tamil Nadu, India
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Badawy M, Revzin MV, Consul N, Soliman M, Ganeshan DM, Heymann JC, Gaballah AH, Rao Korivi B, Morani AC, Javadi S, Elsayes KM. Paraneoplastic Syndromes from Head to Toe: Pathophysiology, Imaging Features, and Workup. Radiographics 2023; 43:e220085. [PMID: 36795597 DOI: 10.1148/rg.220085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/17/2023]
Abstract
Patients often have symptoms due to the mass effect of a neoplasm on surrounding tissues or the development of distant metastases. However, some patients may present with clinical symptoms that are not attributable to direct tumor invasion. In particular, certain tumors may release substances such as hormones or cytokines or trigger an immune cross-reactivity between malignant and normal body cells, resulting in characteristic clinical features that are broadly referred to as paraneoplastic syndromes (PNSs). Recent advances in medicine have improved the understanding of the pathogenesis of PNSs and enhanced their diagnosis and treatment. It is estimated that 8% of patients with cancer develop a PNS. Diverse organ systems may be involved, most notably the neurologic, musculoskeletal, endocrinologic, dermatologic, gastrointestinal, and cardiovascular systems. Knowledge of various PNSs is necessary, as these syndromes may precede tumor development, complicate the patient's clinical presentation, indicate tumor prognosis, or be mistaken for metastatic spread. Radiologists should be familiar with the clinical presentations of common PNSs and the selection of appropriate imaging examinations. Many of these PNSs have imaging features that can assist with arriving at the correct diagnosis. Therefore, the key radiographic findings associated with these PNSs and the diagnostic pitfalls that can be encountered during imaging are important, as their detection can facilitate early identification of the underlying tumor, reveal early recurrence, and enable monitoring of the patient's response to therapy. © RSNA, 2023 Quiz questions for this article are available in the supplemental material.
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Affiliation(s)
- Mohamed Badawy
- From the Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (M.B., D.M.G., B.R.K., A.C.M., S.J., K.M.E.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Diagnostic Radiology, Baylor College of Medicine, Houston, Tex (N.C.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.S.); Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, Tex (J.C.H.); and Department of Radiology, University of Missouri School of Medicine, Columbia, Mo (A.H.G.)
| | - Margarita V Revzin
- From the Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (M.B., D.M.G., B.R.K., A.C.M., S.J., K.M.E.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Diagnostic Radiology, Baylor College of Medicine, Houston, Tex (N.C.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.S.); Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, Tex (J.C.H.); and Department of Radiology, University of Missouri School of Medicine, Columbia, Mo (A.H.G.)
| | - Nikita Consul
- From the Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (M.B., D.M.G., B.R.K., A.C.M., S.J., K.M.E.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Diagnostic Radiology, Baylor College of Medicine, Houston, Tex (N.C.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.S.); Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, Tex (J.C.H.); and Department of Radiology, University of Missouri School of Medicine, Columbia, Mo (A.H.G.)
| | - Moataz Soliman
- From the Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (M.B., D.M.G., B.R.K., A.C.M., S.J., K.M.E.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Diagnostic Radiology, Baylor College of Medicine, Houston, Tex (N.C.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.S.); Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, Tex (J.C.H.); and Department of Radiology, University of Missouri School of Medicine, Columbia, Mo (A.H.G.)
| | - Dhakshina M Ganeshan
- From the Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (M.B., D.M.G., B.R.K., A.C.M., S.J., K.M.E.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Diagnostic Radiology, Baylor College of Medicine, Houston, Tex (N.C.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.S.); Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, Tex (J.C.H.); and Department of Radiology, University of Missouri School of Medicine, Columbia, Mo (A.H.G.)
| | - John C Heymann
- From the Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (M.B., D.M.G., B.R.K., A.C.M., S.J., K.M.E.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Diagnostic Radiology, Baylor College of Medicine, Houston, Tex (N.C.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.S.); Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, Tex (J.C.H.); and Department of Radiology, University of Missouri School of Medicine, Columbia, Mo (A.H.G.)
| | - Ayman H Gaballah
- From the Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (M.B., D.M.G., B.R.K., A.C.M., S.J., K.M.E.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Diagnostic Radiology, Baylor College of Medicine, Houston, Tex (N.C.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.S.); Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, Tex (J.C.H.); and Department of Radiology, University of Missouri School of Medicine, Columbia, Mo (A.H.G.)
| | - Brinda Rao Korivi
- From the Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (M.B., D.M.G., B.R.K., A.C.M., S.J., K.M.E.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Diagnostic Radiology, Baylor College of Medicine, Houston, Tex (N.C.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.S.); Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, Tex (J.C.H.); and Department of Radiology, University of Missouri School of Medicine, Columbia, Mo (A.H.G.)
| | - Ajaykumar C Morani
- From the Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (M.B., D.M.G., B.R.K., A.C.M., S.J., K.M.E.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Diagnostic Radiology, Baylor College of Medicine, Houston, Tex (N.C.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.S.); Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, Tex (J.C.H.); and Department of Radiology, University of Missouri School of Medicine, Columbia, Mo (A.H.G.)
| | - Sanaz Javadi
- From the Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (M.B., D.M.G., B.R.K., A.C.M., S.J., K.M.E.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Diagnostic Radiology, Baylor College of Medicine, Houston, Tex (N.C.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.S.); Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, Tex (J.C.H.); and Department of Radiology, University of Missouri School of Medicine, Columbia, Mo (A.H.G.)
| | - Khaled M Elsayes
- From the Department of Diagnostic Imaging, The University of Texas MD Anderson Cancer Center, 1400 Pressler St, Houston, TX 77030 (M.B., D.M.G., B.R.K., A.C.M., S.J., K.M.E.); Department of Radiology and Biomedical Imaging, Yale University School of Medicine, New Haven, Conn (M.V.R.); Department of Diagnostic Radiology, Baylor College of Medicine, Houston, Tex (N.C.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (M.S.); Department of Diagnostic Radiology, University of Texas Medical Branch, Galveston, Tex (J.C.H.); and Department of Radiology, University of Missouri School of Medicine, Columbia, Mo (A.H.G.)
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Broderick A, Labriola MK, Shore N, Armstrong AJ. Foreign accent syndrome as a heralding manifestation of transformation to small cell neuroendocrine prostate cancer. BMJ Case Rep 2023; 16:e251655. [PMID: 36717160 PMCID: PMC9887694 DOI: 10.1136/bcr-2022-251655] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
A man in his 50s with metastatic hormone-sensitive prostate cancer, receiving androgen deprivation therapy and abiraterone acetate/prednisone, presented with an uncontrollable 'Irish brogue' accent despite no Irish background, consistent with foreign accent syndrome (FAS). He had no neurological examination abnormalities, psychiatric history or MRI of the brain abnormalities at symptom onset. Imaging revealed progression of his prostate cancer, despite undetectable prostate-specific antigen levels. Biopsy confirmed transformation to small cell neuroendocrine prostate cancer (NEPC). Despite chemotherapy, his NEPC progressed resulting in multifocal brain metastases and a likely paraneoplastic ascending paralysis leading to his death. We report FAS as the presenting manifestation of transformation to small cell NEPC, a previously undescribed phenomenon. His presentation was most consistent with an underlying paraneoplastic neurological disorder (PND), despite a negative serum paraneoplastic panel. This report enhances the minimal existing literature on FAS and PNDs associated with transformed NEPC.
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Affiliation(s)
- Amanda Broderick
- Department of Internal Medicine, Duke University Health System, Durham, North Carolina, USA
| | - Matthew K Labriola
- Division of Medical Oncology, Department of Medicine, Duke University, Durham, North Carolina, USA
| | - Neal Shore
- Carolina Urologic Research Center, Myrtle Beach, South Carolina, USA
| | - Andrew J Armstrong
- Divisions of Medical Oncology and Urology, Duke Cancer Institute Center for Prostate and Urologic Cancers, Duke University, Durham, North Carolina, USA
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7
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Murvelashvili N, Polanco PM, Khorsand SM, Marrero JA, Jia L, Mirfakhraee S, Else T, Habra MA, Cole S, Hamidi O. Severe Cholestatic Jaundice (Stauffer Syndrome) as a Rare Paraneoplastic Manifestation in Adrenocortical Carcinoma. J Endocr Soc 2022; 6:bvac101. [DOI: 10.1210/jendso/bvac101] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2022] [Indexed: 11/19/2022] Open
Abstract
Abstract
Background
Adrenocortical carcinoma (ACC) is a rare malignancy arising from the adrenal cortex. While ACC can be associated with adrenal hormone excess syndromes, classic paraneoplastic syndromes are rarely seen. Stauffer syndrome, a paraneoplastic phenomenon characterized by reversible cholestasis in the absence of liver metastases, has been described with renal carcinoma and other malignancies but has not been previously reported in ACC.
Case Presentation
A 38-year-old man presented with emesis, painless jaundice, pruritus, and weight loss. Laboratory evaluation demonstrated elevated total bilirubin of 8.7 mg/dL (N<1.3). Computed tomography revealed a 20.4-cm left adrenal mass without evidence of liver metastases. The patient's condition deteriorated rapidly with progressive renal failure and worsening hyperbilirubinemia. The patient underwent left adrenalectomy, nephrectomy, ureterolysis, and wedge liver biopsy. Histopathology showed necrotic ACC with tumor invasion into the adrenal capsule, no lymphovascular invasion, uninvolved margins, and Ki-67 of 40%. Kidney parenchyma exhibited diffuse pigment casts. The liver specimen contained diffuse bile deposits and minimal chronic inflammation in the portal tracts. He tested positive for pathogenic variant of folliculin (FLCN) gene consistent with Birt-Hogg-Dubé syndrome. Renal function recovered after surgery, and bilirubin level normalized after several weeks. Based on clinical presentation and absence of other etiologies, reversible cholestatic jaundice was attributed to Stauffer syndrome.
Conclusions
This is the first report of a unique presentation of paraneoplastic-related hyperbilirubinemia in the setting of ACC. While extremely rare, Stauffer syndrome should still be considered in differential diagnosis in patients with ACC with liver dysfunction and jaundice without evidence of liver metastases.
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Affiliation(s)
- Natia Murvelashvili
- Division of Endocrinology and Metabolism, UT Southwestern Medical Center , Dallas, TX
| | - Patricio M Polanco
- Division of Surgical Oncology, UT Southwestern Medical Center , Dallas, TX
| | - Sarah M Khorsand
- Department of Anesthesiology and Pain Management, UT Southwestern Medical Center , Dallas, TX
| | - Jorge A Marrero
- Division of Gastroenterology and Hepatology, University of Pennsylvania , Philadelphia, PA
| | - Liwei Jia
- Department of Pathology, UT Southwestern Medical Center , Dallas, TX
| | - Sasan Mirfakhraee
- Division of Endocrinology and Metabolism, UT Southwestern Medical Center , Dallas, TX
| | - Tobias Else
- Division Division of Metabolism, Endocrinology and Diabetes, University of Michigan , Ann Arbor, MI
| | - Mouhammed Amir Habra
- Department of Endocrine Neoplasia and Hormonal Disorders, University of Texas MD Anderson Cancer Center , Houston, TX
| | - Suzanne Cole
- Division of Hematology and Oncology, UT Southwestern Medical Center , Dallas, TX
| | - Oksana Hamidi
- Division of Endocrinology and Metabolism, UT Southwestern Medical Center , Dallas, TX
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Basaran E, Kucukoztas N, Aktepe HO, Atak Tel B, Aktas G. An exceptional prostate cancer case: Importance of cancer screening. PRECISION MEDICAL SCIENCES 2022. [DOI: 10.1002/prm2.12063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Elif Basaran
- Department of Internal Medicine Abant Izzet Baysal University Hospital Bolu Turkey
| | - Nadire Kucukoztas
- Department of Medical Oncology Abant Izzet Baysal University Hospital Bolu Turkey
| | - Halit Oktay Aktepe
- Department of Medical Oncology Abant Izzet Baysal University Hospital Bolu Turkey
| | - Burcin Atak Tel
- Department of Internal Medicine Abant Izzet Baysal University Hospital Bolu Turkey
| | - Gulali Aktas
- Department of Internal Medicine Abant Izzet Baysal University Hospital Bolu Turkey
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Vignes S, Fourgeaud C, Michon-Pasturel U. Un syndrome des orteils bleus révélant un cancer de la prostate métastatique : une observation avec analyse de la littérature. Rev Med Interne 2022; 43:562-565. [DOI: 10.1016/j.revmed.2022.04.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2022] [Revised: 04/02/2022] [Accepted: 04/09/2022] [Indexed: 11/25/2022]
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10
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Arman T, Nelson PS. Endocrine and paracrine characteristics of neuroendocrine prostate cancer. Front Endocrinol (Lausanne) 2022; 13:1012005. [PMID: 36440195 PMCID: PMC9691667 DOI: 10.3389/fendo.2022.1012005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2022] [Accepted: 10/24/2022] [Indexed: 11/12/2022] Open
Abstract
Prostate cancer is a common malignancy affecting men worldwide. While the vast majority of newly diagnosed prostate cancers are categorized as adenocarcinomas, a spectrum of uncommon tumor types occur including those with small cell and neuroendocrine cell features. Benign neuroendocrine cells exist in the normal prostate microenvironment, and these cells may give rise to primary neuroendocrine carcinomas. However, the more common development of neuroendocrine prostate cancer is observed after therapeutics designed to repress the signaling program regulated by the androgen receptor which is active in the majority of localized and metastatic adenocarcinomas. Neuroendocrine tumors are identified through immunohistochemical staining for common markers including chromogranin A/B, synaptophysin and neuron specific enolase (NSE). These markers are also common to neuroendocrine tumors that arise in other tissues and organs such as the gastrointestinal tract, pancreas, lung and skin. Notably, neuroendocrine prostate cancer shares biochemical features with nerve cells, particularly functions involving the secretion of a variety of peptides and proteins. These secreted factors have the potential to exert local paracrine effects, and distant endocrine effects that may modulate tumor progression, invasion, and resistance to therapy. This review discusses the spectrum of factors derived from neuroendocrine prostate cancers and their potential to influence the pathophysiology of localized and metastatic prostate cancer.
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Affiliation(s)
- Tarana Arman
- Division of Human Biology, Fred Hutchinson Cancer Center, Seattle, WA, United States
| | - Peter S. Nelson
- Division of Human Biology, Fred Hutchinson Cancer Center, Seattle, WA, United States
- Division of Clinical Research, Fred Hutchinson Cancer Center, Seattle, WA, United States
- *Correspondence: Peter S. Nelson,
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Haq MS, Thomas PM, Almonte M, Mohan V. Prostate Cancer Presenting With an Unusual Presentation of Rectal Pain and Bleeding. Cureus 2021; 13:e18766. [PMID: 34804647 PMCID: PMC8592291 DOI: 10.7759/cureus.18766] [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] [Accepted: 10/09/2021] [Indexed: 12/03/2022] Open
Abstract
We report an atypical case of prostate cancer with rectal involvement presenting with gastrointestinal symptoms predominately and a rectal mass. A 51-year-old male patient came to the hospital with abdominal pain and rectal bleeding. Imaging revealed prostate enlargement, perirectal lymphadenopathy, and multiple hepatic and pulmonary nodules. The patient also had an elevated prostate-specific antigen (PSA) of 502 ng/mL (against normal range 0.6-0.7 ng/mL). Biopsies were performed on tissue samples taken from the rectum and prostate gland, which confirmed the diagnosis of prostate adenocarcinoma. The lack of urinary symptoms and close clinical similarity to colorectal cancer presented a diagnostic challenge for us. Familiarity with this specific presentation of prostate cancer is necessary to avoid misdiagnoses and guide correct treatment.
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Affiliation(s)
- Muhammad S Haq
- Internal Medicine, Saint Francis Medical Center, Trenton, USA
| | - Pravin M Thomas
- Internal Medicine, Saint Francis Medical Center, Trenton, USA
| | - Marcos Almonte
- Internal Medicine, Saint Francis Medical Center, Trenton, USA
| | - Vinuta Mohan
- Internal Medicine: Endocrinology, Saint Francis Medical Center, Trenton, USA
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Ghafouri SR, Escriba-Omar A, Wahdatyar I, Whited N, Hakim MN, Gaur S, Dihowm F. Exfoliative Dermatitis as a Para-neoplastic Syndrome of Prostate Adenocarcinoma: A Rare Case Report With Literature Review. CANCER DIAGNOSIS & PROGNOSIS 2021; 1:289-295. [PMID: 35403136 PMCID: PMC8988963 DOI: 10.21873/cdp.10038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 06/14/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND/AIM This study aimed to report a rare case of erythroderma or exfoliative dermatitis as a paraneoplastic syndrome of prostate adenocarcinoma. Exfoliative dermatitis is a rare inflammatory skin condition that is characterized by desquamation and erythema involving more than 90% of the body surface area. It is a clinical manifestation and usually associated with various underlying cutaneous disorders, drug induced reactions and malignancies. CASE REPORT Herein we report a case of 55-year-old male patient who presented with progressively diffuse scaling and erythematous rash of 3 months duration. He was diagnosed with untreated prostate adenocarcinoma about 2 months prior his admission. Skin biopsy confirmed exfoliative erythroderma diagnosis. He was investigated extensively for other pathologies, however all work up remained negative except a CT finding of large heterogeneous prostate gland with elevated PSA which was consistent with prostate cancer. Daily oral prednisone for one week and hydrocortisone cream provided partial clinical improvement. The patient was discharged on tapering steroid to follow-up with urology and oncology for further underlying prostate carcinoma management. CONCLUSION We concluded that the ongoing erythroderma was a paraneoplastic syndrome of prostate adenocarcinoma. Hence, early detailed history and routine screening of malignancy-related biomarkers is warranted on any individuals presenting with such symptoms.
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Affiliation(s)
- Sayed Reshad Ghafouri
- Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A
| | - Abelardo Escriba-Omar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A
| | - Inayatullah Wahdatyar
- Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A
| | - Noah Whited
- Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A
| | - Mohammad Nawar Hakim
- Department of Pathology, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A
| | - Sumit Gaur
- Department of Haematology and Oncology, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A
| | - Fatma Dihowm
- Department of Internal Medicine, Texas Tech University Health Sciences Center, El Paso, TX, U.S.A
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Kim YJ, Choi SM, Kim TG. Bilateral Calcific Band Keratopathy Treated with Dipotassium Edetic Acid. JOURNAL OF THE KOREAN OPHTHALMOLOGICAL SOCIETY 2021. [DOI: 10.3341/jkos.2021.62.5.692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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14
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Gibb J, Babawale O, Phan YC, Karim O. Dermatological manifestation of metastatic prostate cancer. BMJ Case Rep 2020; 13:13/11/e237115. [PMID: 33257377 DOI: 10.1136/bcr-2020-237115] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 59-year-old man presented to the urology department with increased urinary urgency, frequency, poor urinary flow and unintentional weight loss. He had a 25-year history of idiopathic urticaria episodes which had increased in frequency over the previous 2 months. On investigation, he was found to have a raised prostate-specific antigen level. He was investigated further with a multiparametric MRI, a local anaesthetic transperineal prostate biopsy, a CT scan of chest/abdomen/pelvis with contrast and a nuclear medicine bone scan. He was diagnosed with metastatic adenocarcinoma of the prostate and commenced on a luteinising hormone-releasing hormone antagonist and referred to oncology for further treatment. Since starting treatment, he has experienced no further episodes of urticaria.
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Affiliation(s)
- Julia Gibb
- Urology, Queen Alexandra Hospital, Portsmouth, UK
| | - Omikunle Babawale
- Urology, Queen Alexandra Hospital, Portsmouth, UK.,Medicine, Imperial College London, London, UK
| | | | - Omer Karim
- Urology, Queen Alexandra Hospital, Portsmouth, UK
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15
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Metastatic Parathyroid Hormone-Secreting Prostate Adenocarcinoma Mimicking Ectopic Parathyroid Adenoma Demonstrated on 99mTc-MIBI Image. Clin Nucl Med 2020; 45:555-556. [PMID: 32453086 DOI: 10.1097/rlu.0000000000003064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Tc-MIBI has long been used to localize hyperfunctioning parathyroid tissue in patients with hyperparathyroidism. This tracer can also concentrate in various neoplastic tissues including prostate adenocarcinoma. We herein report a case with parathyroid hormone-secreting metastatic prostate cancer mimicking an ectopic parathyroid adenoma on the Tc-MIBI scan. We conclude that metastatic prostate cancer should be included as one of the differential diagnoses when interpreting Tc-MIBI scan.
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16
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Danny GC, Swaminathan A, Rajesh G, Veeraraghavan M. Paraneoplastic Erythroderma as a Protean Manifestation of Adenocarcinoma Prostate. Indian J Dermatol 2020; 65:72-74. [PMID: 32029949 PMCID: PMC6986123 DOI: 10.4103/ijd.ijd_189_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Geo Celestin Danny
- Department of Dermatology, Sri Ramachandra University, Chennai, Tamil Nadu, India. E-mail:
| | | | - Gayathri Rajesh
- Department of Dermatology, Sri Ramachandra University, Chennai, Tamil Nadu, India. E-mail:
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17
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Gökçen P, Gökçen K, Çakmak E, Gökçe G. Paraneoplastic hyperbilirubinemia in metastatic prostate cancer and review of the current literature. Turk J Urol 2019; 45:70-72. [PMID: 30668309 PMCID: PMC6342570 DOI: 10.5152/tud.2018.52059] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 10/03/2017] [Indexed: 11/22/2022]
Abstract
Paraneoplastic syndromes are functional clinical disorders caused by the direct effect of the primary tumor or metastasis. The initial presenting symptom of the patients may be associated with paraneoplastic manifestations. Paraneoplastic cholestasis is most frequently defined in association with renal cell carcinoma (Stauffer's syndrome), but it is an extremely rare clinical entity seen in association with prostate cancer. Etiology of cholestasis was investigated in the case diagnosed as metastatic prostate cancer who applied to the gastroenterology outpatient clinic due to complaints of ascites and jaundice that established the diagnosis of paraneoplastic hyperbilirubinemia. We observed improvement of his cholestasis with hormonotherapy used for prostate cancer.
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Affiliation(s)
- Pınar Gökçen
- Department of Gastroenterology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Kaan Gökçen
- Department of Urology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Erol Çakmak
- Department of Gastroenterology, Cumhuriyet University School of Medicine, Sivas, Turkey
| | - Gökhan Gökçe
- Department of Urology, Cumhuriyet University School of Medicine, Sivas, Turkey
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18
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Phan YC, Shammout S, Cobley J, Hayes M, Akhtar M, Powell J. Metastatic prostate cancer presenting as subacute cutaneous lupus erythematosus. Australas J Dermatol 2019; 61:e113-e114. [DOI: 10.1111/ajd.13133] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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19
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Duncan C, Zamir E, Teh J, Joon DL, Liodakis P. A blind spot in urology: Prostate cancer associated retinopathy. Urol Case Rep 2019; 24:100872. [PMID: 31211081 PMCID: PMC6562331 DOI: 10.1016/j.eucr.2019.100872] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2019] [Accepted: 03/14/2019] [Indexed: 11/24/2022] Open
Abstract
Paraneoplastic syndromes associated with prostate cancer that cause visual disturbances are rare. We present the case of a 71 year old man with a history of adenocarcinoma of the prostate who developed cancer associated retinopathy concomitant with small cell transformation. This represents an unusual paraneoplastic syndrome that may be progressive and irreversible, requiring prompt diagnosis and treatment to preserve visual function and guide further oncological care.
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Affiliation(s)
- Catriona Duncan
- Department of Urology, Austin Health, Melbourne, Australia
- Young Urology Research Organization (YURO), Australia
- North Eastern Urology, Heidelberg, Victoria, Australia
- Corresponding author. Department of Urology, Austin Health, Melbourne, Australia.
| | - Ehud Zamir
- McKinnon Eye Clinic, Victoria, Australia
| | - Jiasian Teh
- Department of Urology, Austin Health, Melbourne, Australia
- Young Urology Research Organization (YURO), Australia
| | - Daryl Lim Joon
- Department of Radiation Oncology, Olivia Newtown John Cancer Centre, Heidelberg, Victoria, Australia
| | - Peter Liodakis
- Department of Urology, Austin Health, Melbourne, Australia
- North Eastern Urology, Heidelberg, Victoria, Australia
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20
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Clinical characteristics, treatment outcomes and potential novel therapeutic options for patients with neuroendocrine carcinoma of the prostate. Oncotarget 2019; 10:17-29. [PMID: 30713600 PMCID: PMC6343754 DOI: 10.18632/oncotarget.26523] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2018] [Accepted: 12/10/2018] [Indexed: 12/21/2022] Open
Abstract
Background Neuroendocrine carcinomas of the prostate (NEPCs) are rare tumors with poor prognosis. While platinum and etoposide-based chemotherapy regimens (PE) are commonly applied in first-line for advanced disease, evidence for second-line therapy and beyond is very limited. Methods Retrospective analysis of all patients with NEPCs including mixed differentiation with adenocarcinoma component and well differentiated neuroendocrine tumors (NETs, carcinoids) at two high-volume oncological centers between 12/2000 and 11/2017. Results Of 46 identified patients 39.1 % had a prior diagnosis of prostatic adenocarcinoma only, 43.5 % had a mixed differentiation at NEPC diagnosis, 67.4 % developed visceral metastases, 10.9 % showed paraneoplastic syndromes. Overall survival (OS) from NEPC diagnosis was 15.5 months, and significantly shorter in patients with a prior prostatic adenocarcinoma (5.4 vs. 32.7 months, p=0.005). 34 patients received palliative first-line systemic therapy with a median progression-free survival (PFS) of 6.6 months, mostly PE. Overall response rate (ORR) for PE was 48.1 %. 19 patients received second-line therapy, mostly with poor responses. Active regimens were topotecan (1 PR, 3 PD), enzalutamide (1 SD), abiraterone (1 SD), FOLFIRI (1 SD), and ipilimumab+nivolumab (1 PR). One patient with prostatic carcinoid was sequentially treated with octreotide, peptide receptor radionuclide therapy and everolimus, and survived for over 9 years. Conclusions EP in first-line shows notable ORR, however limited PFS. For second-line therapy, topotecan, FOLFIRI, enzalutamide, abiraterone and immune checkpoint blockade are treatment options. Prostatic carcinoids can be treated in analogy to well differentiated gastrointestinal NETs.
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21
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Papagoras C, Arelaki S, Botis I, Chrysafis I, Giannopoulos S, Skendros P. Co-occurrence of Dermatomyositis and Polycythemia Unveiling Rare de Novo Neuroendocrine Prostate Tumor. Front Oncol 2018; 8:534. [PMID: 30524963 PMCID: PMC6256116 DOI: 10.3389/fonc.2018.00534] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2018] [Accepted: 10/30/2018] [Indexed: 12/24/2022] Open
Abstract
We present a case of dermatomyositis together with polycythemia as initial manifestations of a particularly rare type of prostate cancer. A 69-year-old man was hospitalized for facial erythema and symptoms of fatigue. Physical evaluation, serum creatinine phosphokinase and electromyography were consistent with dermatomyositis. In parallel, the hemoglobin level was 18.5 g/dL, serum erythropoietin levels were low normal and no JAK2 mutation was found. Given a strong suspicion of a paraneoplastic syndrome the patient underwent abdominal computed tomography revealing a prostate mass, enlarged iliac lymph nodes and a fracture of L1 due to metastasis. The unusual paraneoplastic manifestations prompted a more thorough immunohistologic examination of the needle biopsy specimen taken from the prostate, which led to the diagnosis of large cell neuroendocrine prostate carcinoma. It is a most rare type of prostate cancer, carrying a poor prognosis. To our knowledge, this is the first case in the literature associating a neuroendocrine cancer of the prostate with dermatomyositis.
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Affiliation(s)
- Charalampos Papagoras
- First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Stella Arelaki
- Department of Pathology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ioannis Botis
- First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Ioannis Chrysafis
- Department of Radiology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Stavros Giannopoulos
- Department of Urology, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
| | - Panagiotis Skendros
- First Department of Internal Medicine, University Hospital of Alexandroupolis, Democritus University of Thrace, Alexandroupolis, Greece
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22
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Fontes-Sousa M, Magalhães H, da Silva FC, Maurício MJ. Stauffer's syndrome: A comprehensive review and proposed updated diagnostic criteria. Urol Oncol 2018; 36:321-326. [PMID: 29657090 DOI: 10.1016/j.urolonc.2018.01.019] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2017] [Revised: 12/07/2017] [Accepted: 01/28/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND Stauffer's syndrome corresponds to a set of clinical and analytical changes of paraneoplastic nature firstly recognized more than 50 years ago, in association to renal cell carcinoma. A definitive review including universal diagnostic criteria and updated knowledge since the original description is lacking. BASIC PROCEDURES The authors conducted a comprehensive bibliographical review and propose updated diagnostic criteria to standardize diagnosis for clinical practice purposes and avoid misclassification. MAIN FINDINGS Although having been described in association with renal cell carcinoma, the syndrome has been reported in correlation with other malignancies-either solid or hematological tumors. Additionally, a variant syndrome presenting with jaundice has also been characterized, but appears to have a similar clinical course to that of the classical Stauffer's syndrome. Although often described as rare, it may be more frequent than previously recognized. Stauffer's syndrome etiopathogenesis is still poorly understood, but immune mechanisms seem to play a role underscored by the malignancies to which the syndrome is associated, several of which having immunotherapy drugs approved for their treatment. PRINCIPAL CONCLUSIONS A set of diagnostic criteria should be used to simplify, broaden and standardized diagnosis, under the entity characterized by reversible paraneoplastic intrahepatic cholestasis. Clinicians should be aware of the syndrome, namely consider further investigation if a plausible cause for unexplained intrahepatic cholestasis in an otherwise healthy patient is not found. Even though no universal approach is available, investigation should be considered regarding metastatic disease after resection of a primary tumor which has revealed persistence or recurrence of symptoms.
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Affiliation(s)
- Mário Fontes-Sousa
- Department of Medical Oncology, Portuguese Oncology Institute of Porto, Porto, Portugal; Portuguese Genitourinary Group (GPGU), Lisbon, Portugal.
| | - Helena Magalhães
- Department of Medical Oncology, Portuguese Oncology Institute of Porto, Porto, Portugal; Portuguese Genitourinary Group (GPGU), Lisbon, Portugal
| | | | - Maria Joaquina Maurício
- Department of Medical Oncology, Portuguese Oncology Institute of Porto, Porto, Portugal; Portuguese Genitourinary Group (GPGU), Lisbon, Portugal
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Abstract
RATIONALE Paraneoplastic syndrome is a very rare syndrome among prostate cancer patients. In particular, paraneoplastic sensorimotor neuropathy has never been reported as a complication of prostatic adenocarcinoma. PATIENT CONCERNS A 75-year-old man who was diagnosed with prostatic adenocarcinoma with multiple metastases received cancer treatment. But, numbness and tingling sensations in both sides of the upper and lower limbs got progressively worse. DIAGNOSESE He was diagnosed with positive anti-Hu antibodies paraneoplastic sensorimotor polyneuropathy caused by prostatic adenocarcinoma. INTERVENTIONS The patient received physical therapy, occupational therapy, and opioid medication during 3 weeks at cancer rehabilitation department during 3 weeks. OUTCOMES There was no improvement in functional outcome in this patient. But, the patient's neuropathic pain was improved by the use of opioid agents. LESSONS This case report is the first to report anti-Hu antibody-positive paraneoplastic sensorimotor neuropathy in a patient with adenocarcinoma of the prostate.
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Affiliation(s)
- Jong Kyoung Choi
- Department of Rehabilitation Medicine, Dong-Eui Medical Center, Busan
| | - Won Jun Kim
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
| | - Jae Yong Jeon
- Department of Rehabilitation Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea
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24
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Metastatic Prostate Cancer Manifesting as Cholestatic Jaundice: A Case Report and Review of the Literature. Case Rep Oncol Med 2018; 2018:1809432. [PMID: 29780650 PMCID: PMC5892301 DOI: 10.1155/2018/1809432] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2017] [Accepted: 02/26/2018] [Indexed: 11/18/2022] Open
Abstract
A paraneoplastic syndrome can often present as the first manifestation of an underlying malignancy. We report a patient who presented with cholestatic jaundice as a paraneoplastic syndrome from his newly diagnosed metastatic prostate cancer. He received initial treatment with androgen deprivation therapy followed by six cycles of docetaxel resulting in resolution of his cholestatic process, normalization of liver enzyme levels, and excellent biochemical and radiographic response. To the best of our knowledge, this is the first reported case of metastatic prostate cancer with cholestatic jaundice as a paraneoplastic phenomenon to be safely treated with androgen deprivation therapy and upfront docetaxel, reflecting the latest shift in the treatment of metastatic prostate cancer.
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25
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Cadmus SD, Pearlstein MV, Pearlstein KA, Googe PB, Jolly PS. Paraneoplastic psoriasis in a patient with prostate cancer. JAAD Case Rep 2018; 4:220-221. [PMID: 29687053 PMCID: PMC5909472 DOI: 10.1016/j.jdcr.2017.09.014] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Affiliation(s)
- Simi D Cadmus
- University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - Michelle V Pearlstein
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina
| | - Kevin A Pearlstein
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, North Carolina
| | - Paul B Googe
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina
| | - Puneet S Jolly
- Department of Dermatology, University of North Carolina, Chapel Hill, North Carolina
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26
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Kampe KKW, Rotermund R, Tienken M, Thomalla G, Regier M, Klutmann S, Kluge S. Diagnostic Value of Positron Emission Tomography Combined with Computed Tomography for Evaluating Critically Ill Neurological Patients. Front Neurol 2017; 8:33. [PMID: 28261149 PMCID: PMC5306377 DOI: 10.3389/fneur.2017.00033] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2016] [Accepted: 01/24/2017] [Indexed: 12/13/2022] Open
Abstract
Purpose 18F-fluorodeoxyglucose positron emission tomography combined with computed tomography (FDG-PET/CT) is a promising new tool for the identification of inflammatory, infectious, and neoplastic foci. The aim of our work was to evaluate the diagnostic value of FDG-PET/CT in patients treated on a neurological/neurosurgical ICU or stroke unit. Methods We performed a single-center, 10-year, retrospective evaluation of the value of FDG-PET/CT in critically ill adult patients with severe neurological disease. Results 42 patients underwent FDG-PET/CT. Of these, 15 were ventilated and 10 were under vasopressor support. We identified four indications for performing FDG-PET/CT: (1) excluding a paraneoplastic etiology in an otherwise unexplained encephalitis, encephalopathy or neuropathy, (2) detecting a large-vessel vasculitis in patients with ischemic stroke, (3) detecting an infectious focus in sepsis, and less frequently (4) evaluating cerebral metabolism. In 22 patients who were evaluated for an unknown malignancy, 5 scans revealed either a previously unknown tumor or unknown metastases of a previously treated malignancy. Of 11 patients investigated for large-vessel vasculitis, 2 showed an inflammation of arteries supplying the brain. Of six sepsis cases, FDG-PET/CT identified an infectious focus in four. Summary We found FDG-PET/CT to be a helpful tool in critically ill neurological patients. The results of the FDG-PET/CT had direct therapeutic consequences in the 12 true-positive cases. In 24 of the 29 negative cases, FDG-PET/CT helped exclude alternative diagnoses and/or influenced therapy. Our findings demonstrate the feasibility and diagnostic benefit of FDG-PET/CT in this group of patients.
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Affiliation(s)
- Knut Kurt William Kampe
- Department of Intensive Care, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Roman Rotermund
- Department of Intensive Care, University Medical Center Hamburg-Eppendorf, Hamburg, Germany; Department of Neurosurgery, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Milena Tienken
- Nuclear Medicine, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Götz Thomalla
- Department of Neurology, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Marc Regier
- Diagnostic and Interventional Radiology, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Susanne Klutmann
- Nuclear Medicine, Department of Diagnostic and Interventional Radiology and Nuclear Medicine, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
| | - Stefan Kluge
- Department of Intensive Care, University Medical Center Hamburg-Eppendorf , Hamburg , Germany
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Buchwald P, Diesing L, Dixon L, Wakeman C, Eglinton T, Dobbs B, Frizelle F. Cohort study of mesenteric panniculitis and its relationship to malignancy. Br J Surg 2016; 103:1727-1730. [DOI: 10.1002/bjs.10229] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2016] [Revised: 04/13/2016] [Accepted: 05/13/2016] [Indexed: 01/10/2023]
Abstract
Abstract
Background
Mesenteric panniculitis (MP) is a rare condition that historically has been associated with the presence of malignancy. Paraneoplastic phenomena in general regress with cure and in most cases with treatment of the cancer. This study was undertaken to determine whether MP regressed with cancer treatment and cure.
Methods
This was a retrospective review of a database of all patients with MP confirmed on CT between 2003 and August 2015 at Christchurch Hospital. Patients were categorized as having malignant or non-malignant disease, and follow-up scans were assessed for remission of MP. Patients with malignancy were further categorized as having malignancy cured or not cured.
Results
A total of 308 patients were identified with possible MP; 135 were excluded as radiological appearances were not typical of MP (43 patients) or there was no follow-up CT (92). Of 173 patients (131 men) included, 75 (43·4 per cent) were diagnosed with malignancy. Follow-up imaging showed that 33 patients (19·1 per cent) had remission of MP, whereas 140 (80·9 per cent) had no remission. There was no difference in the rates of MP remission in the malignancy versus no malignancy groups (P = 1·000), or between groups in which malignancy was cured or not cured (P = 0·572). Nor was there any difference in the rates of MP remission in malignancy cured versus no malignancy groups (P = 0·524).
Conclusion
MP does not behave like a paraneoplastic phenomenon. The association with malignancy is most likely an epiphenomenon of the many CT images acquired for staging of cancer.
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Affiliation(s)
- P Buchwald
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch 8011, New Zealand
| | - L Diesing
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch 8011, New Zealand
| | - L Dixon
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch 8011, New Zealand
| | - C Wakeman
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch 8011, New Zealand
| | - T Eglinton
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch 8011, New Zealand
| | - B Dobbs
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch 8011, New Zealand
| | - F Frizelle
- Colorectal Unit, Department of Surgery, Christchurch Hospital, Christchurch 8011, New Zealand
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28
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Prostate cancer, Hu antibodies and paraneoplastic neurological syndromes. J Neurol 2016; 263:1001-1007. [DOI: 10.1007/s00415-016-8090-7] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Revised: 03/04/2016] [Accepted: 03/05/2016] [Indexed: 11/26/2022]
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29
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Termsarasab P, Frucht SJ. Alcohol-responsive Action Myoclonus of the Leg in Prostate Cancer: A Novel Paraneoplastic Syndrome? TREMOR AND OTHER HYPERKINETIC MOVEMENTS (NEW YORK, N.Y.) 2016; 5:357. [PMID: 26759739 PMCID: PMC4707263 DOI: 10.7916/d80g3jsx] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Subscribe] [Scholar Register] [Received: 10/14/2015] [Accepted: 11/16/2015] [Indexed: 01/06/2023]
Abstract
Background Paraneoplastic movement disorders in prostate cancer are rare, and to our knowledge paraneoplastic myoclonus has not previously been reported. Case Report We report two men with adenocarcinoma of the prostate who developed isolated alcohol-responsive action myoclonus of one leg. Myoclonus was absent at rest but triggered by movement, standing, or walking. Evaluations excluded malignant invasion of the nervous system, and testing for commercial paraneoplastic antibodies in serum and cerebrospinal fluid were unrevealing. Both patients experienced significant improvement with alcohol, and sodium oxybate was used in one patient with good initial benefit. Discussion Alcohol-responsive leg myoclonus might be a novel paraneoplastic syndrome associated with prostate cancer. The nature of the syndrome and the source of the myoclonus are currently unknown.
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Affiliation(s)
- Pichet Termsarasab
- Movement Disorder Division, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA; Neurology Division, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand
| | - Steven J Frucht
- Movement Disorder Division, Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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30
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Skin Manifestations of Internal Disease in Older Adults. CURRENT GERIATRICS REPORTS 2015. [DOI: 10.1007/s13670-015-0135-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Aliprandi A, Terruzzi A, Rigamonti A, Bazzigaluppi E, Tremolizzo L, Ferrarese C, Salmaggi A. Paraneoplastic cerebellar degeneration with anti-CV2/CRMP5 antibodies and prostate adenocarcinoma. Neurol Sci 2015; 36:1501-3. [PMID: 25686614 DOI: 10.1007/s10072-015-2113-5] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2014] [Accepted: 02/10/2015] [Indexed: 12/17/2022]
Affiliation(s)
- A Aliprandi
- Neurology-Stroke Unit Division, Department of Neuroscience, "A. Manzoni" Hospital, Lecco, Italy
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Almushayti Z. Hematoma of the psoas muscle, in prostatic cancer patient: a case report. Pan Afr Med J 2015; 20:138. [PMID: 27386016 PMCID: PMC4919696 DOI: 10.11604/pamj.2015.20.138.5152] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2014] [Accepted: 09/27/2014] [Indexed: 11/11/2022] Open
Abstract
We report a case of 64-year-old male with prostate cancer and coagulation disorder presented with abdominal distension. He underwent abdomen and pelvis ultrasound for assessment of ascites, which showed localized fluid collections identified at the left and right iliac fossa. After that, non enhanced abdomen and pelvis CT scan was performed and showed heterogeneous organized collections identified along the psoas muscles bilaterally, causing focal contour bulge representing haematoma.
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Affiliation(s)
- Ziyad Almushayti
- Medical Imaging Department, College of Medicine, Qassim University, Buraydah, Saudi Arabia
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Akin Y, Yucel S, Baykara M. Distal phalangeal necrosis in the extremities as a paraneoplastic syndrome in prostate cancer: an extremely rare case. Urol Int 2013; 93:244-6. [PMID: 24281198 DOI: 10.1159/000354648] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Accepted: 07/25/2013] [Indexed: 11/19/2022]
Abstract
Paraneoplastic syndromes (PNSs) are rare disorders which are triggered by an altered immune system response to a neoplasm. Although prostate cancer (PCa) is the second most common urological malignancy associated with PNSs, literature is lacking in defining the cases representing different PNSs in PCa. Herein, we present a 50-year-old man with fulminant distal phalangeal necrosis in the lower extremities after a diagnosis of PCa. Additionally, we review the literature in light of this case.
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Affiliation(s)
- Yigit Akin
- Department of Urology, Erzincan University School of Medicine, Erzincan, Turkey
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Cholestatic jaundice as a paraneoplastic manifestation of prostate cancer. Case Rep Urol 2013; 2013:303727. [PMID: 24191227 PMCID: PMC3804369 DOI: 10.1155/2013/303727] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2013] [Accepted: 09/11/2013] [Indexed: 11/26/2022] Open
Abstract
Paraneoplastic syndrome associated with prostate cancer is extremely rare. We report a patient who presented with cholestatic jaundice without biliary duct obstruction, hepatic involvement, or infection. After a few detailed examinations, prostate cancer was diagnosed. After treatment with bicalutamide and leuprolide, the patient's symptoms and laboratory abnormalities were reversed. Cholestatic jaundice was regarded as a paraneoplastic manifestation in this patient. The patient remains symptom-free after 14-month followup. Paraneoplastic syndrome should be considered in case of cholestatic jaundice without biliary duct obstruction, hepatic involvement, or infection.
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Jakobsen JK, Zakharia ER, Boysen AK, Andersen H, Schlesinger FE, Lund L. Prostate cancer may trigger paraneoplastic limbic encephalitis: a case report and a review of the literature. Int J Urol 2012. [PMID: 23186204 DOI: 10.1111/iju.12030] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
We present a case of a previously healthy and active 64-year-old man who experienced a rapid neuropsychiatric decline. All tests for metabolic causes, neuroinfection, intracranial infarction or tumor were negative. By the means of magnetic resonance imaging, electroencephalography and the anti-Hu antibody test the patient was diagnosed with paraneoplastic limbic encephalitis related to prostate cancer. The patient died within 6 months. We review the literature on prostate cancer-related paraneoplastic limbic encephalitis. High-risk prostate cancer can trigger paraneoplastic limbic encephalitis, a rapidly progressive neurological syndrome with a bad prognosis.
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36
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Schwartz GG, Skinner HG. A prospective study of total and ionized serum calcium and time to fatal prostate cancer. Cancer Epidemiol Biomarkers Prev 2012; 21:1768-73. [PMID: 22914529 DOI: 10.1158/1055-9965.epi-12-0585] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Higher levels of total and ionized serum calcium have been shown to predict fatal prostate cancer in prospective studies. Because the follow-up time in these studies was relatively short, these associations could reflect the effect of clinically significant but occult prostate tumors on serum calcium levels. If this were true, prostate cancer mortality rates among men with higher levels of serum calcium should be higher during the early follow-up period and should decline thereafter. METHODS We tested this hypothesis by estimating the relative risk of death from prostate cancer in the National Health and Nutrition Examination Survey III for incremental increases in total and ionized serum calcium using Cox proportional hazards regression with time-dependent effects. RESULTS Forty-nine (49) fatal prostate cancers occurred over 204 months of follow-up and 1,069,327 person-months of observation. Men with higher total serum calcium and higher serum ionized calcium had increased risks of fatal prostate cancer during the first 96 months of follow-up [Relative Hazard (RH) = 1.50 per 0.1 mmol/L total serum calcium, 95% confidence interval (CI) = 1.04-2.17; RH = 1.72 per 0.05 mmol/L ionized calcium, 95% CI = 1.11-2.66]. Evidence of an association between total and ionized serum calcium and prostate cancer deaths was not significant after 96 months. CONCLUSIONS Our analyses support the hypothesis that the elevated risk for fatal prostate cancer observed in men with high serum calcium is because of the presence of extant, but occult prostate cancer. IMPACT These findings have implications for the potential use of serum calcium in the detection of clinically significant prostate cancer.
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Affiliation(s)
- Gary G Schwartz
- Department of Cancer Biology, Wake Forest Baptist Medical Center, Winston-Salem, North Carolina, USA
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Jones M, Kobylecki C, Marshall AG, Silverdale MA, Talbot PR. Cerebellar axial postural tremor complicating radiotherapy for prostate cancer. Parkinsonism Relat Disord 2012; 18:680-1. [DOI: 10.1016/j.parkreldis.2011.11.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/27/2011] [Revised: 09/22/2011] [Accepted: 11/14/2011] [Indexed: 01/14/2023]
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Bilateral paraneoplastic optic neuropathy and unilateral retinal compromise in association with prostate cancer: a differential diagnostic challenge in a patient with unexplained visual loss. Doc Ophthalmol 2012; 125:63-70. [PMID: 22569848 DOI: 10.1007/s10633-012-9327-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2012] [Accepted: 04/16/2012] [Indexed: 10/28/2022]
Abstract
We report a 77-year-old Caucasian man with a 1-year complaint of unexplained visual loss and a 4-year history of prostate cancer. A complete ophthalmologic exam, Goldmann visual fields (GVFs), intravenous fluorescein angiography (IVFA), macular and disc optical coherence tomography (OCT), pattern-reversal visual evoked potentials (PVEPs), and flash electroretinograms (ERGs) were performed. On examination, visual acuity was reduced bilaterally. Fundus exam showed juxtapapillary changes (OS > OD) and, in OS, disc pallor, peripheral RPE dropout and whitish retinal discoloration along the arcades. OCTs were normal OU. Cancer-associated retinopathy (CAR) was suspected. A flash ERG was normal OD and markedly reduced and electronegative OS. An IVFA showed bilateral juxtapapillary staining and changes highly suggestive of sequelae of central retinal artery occlusion (CRAO) OS , in which a cilioretinal artery existed along the papillomacular bundle. GVFs showed bilateral blind spot enlargement and centrocecal scotomas, and PVEPs were delayed. These findings suggested cancer-associated optic neuropathy (CAON), confirmed by presence of anti-optic nerve autoantibodies (auto-Abs). No anti-retinal auto-Abs were found. CAON is a less common paraneoplastic manifestation than CAR and it is rarely observed in association with prostate cancer. A combination of visual function testing methods permitted the recognition, in this highly unusual case, of the concurrent presence of unilateral ERG changes most likely attributable to CRAO complications in OS, in all likelihood unrelated to CAON, and not to be confused with unilateral CAR. Auto-Ab testing in combination with visual function tests helps achieve a better understanding of the pathophysiology of vision loss in paraneoplastic visual syndromes.
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Gakiya M, Naka H, Saito S. Paraneoplastic neurological and hematological syndromes associated with prostate cancer. Int J Urol 2012; 19:471-4. [PMID: 22220977 DOI: 10.1111/j.1442-2042.2011.02949.x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Paraneoplastic neurological syndromes are defined as the remote effects of cancer on the nervous system. Here we report a 68-year-old man who initially presented with worsening paresthesia in the lower extremities. Although the culprit lesion remained to be identified, he coincidentally had diagnosis of prostate cancer by an annual prostate-specific antigen examination. Leukocytosis and elevated granulocyte colony-stimulating factor in serum were also detected. Neurological symptoms and leukocytosis improved after initiation of androgen-deprivation therapy followed by external beam radiotherapy. A total of 9 months after treatment, the patient showed no evidence of cancer recurrence or neurological signs. Paraneoplastic neurological syndromes are rare in prostate cancer and therefore have received little attention. We should be aware that when paraneoplastic neurological syndromes occur, they usually occur as the first sign of or during progression of prostate cancer. Furthermore, we should take into account the existence of malignancy when the cause of neurological symptoms cannot be specified.
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Durable remission of leptomeningeal metastases from hormone-responsive prostate cancer. Med Oncol 2011; 29:806-8. [DOI: 10.1007/s12032-011-9906-z] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2011] [Accepted: 03/08/2011] [Indexed: 11/26/2022]
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