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Lee MJ. Prostate cancer invading rectal serosa and anal sphincter treated with definitive radiation therapy: Case report and review of the literature. J Cancer Res Ther 2024; 20:1081-1084. [PMID: 38102902 DOI: 10.4103/jcrt.jcrt_1769_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2020] [Accepted: 01/04/2023] [Indexed: 12/17/2023]
Abstract
ABSTRACT Despite anatomical proximity, prostatic adenocarcinoma with rectal invasion is rare. We describe a case of prostate cancer invading the anal sphincter, treated with radiation therapy (RT). A 78-year-old patient underwent definitive radiotherapy in 2018 because of poorly differentiated adenocarcinoma, Gleason 4 + 3 (7). The initial stage was mrT4N0 on magnetic resonance imaging (MRI) images. The pre-treatment prostate-specific antigen level was 142 ng/mL, and the patient was subjected to androgen deprivation therapy. RT was performed using volumetric modulated arc therapy (VMAT) and a dose of 76 Gy in 38 fractions. After 2 months, MRI showed a complete response. During RT, toxicity was limited to mild gastro-intestinal and urologic symptoms. This report is the first to describe prostate cancer invasion of the anal sphincter and to extend to that condition the use of RT - already regarded as a useful treatment option for inoperable locally advanced high-risk prostate cancer (PC). This study suggests that VMAT can be a safe and effective treatment option for locally advanced high-risk PC patients.
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Affiliation(s)
- Mi-Jo Lee
- Department of Radiation Oncology, Eulji University Hospital, Daejeon, Korea
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Shalata W, Abu Jama A, Abu Salman A, Golosky M, Solomon A, Abu Saleh O, Michlin R, Shalata S, Agbarya A, Yakobson A. Unexpected and Rare Sites of Metastasis in Oncologic Patients. J Clin Med 2023; 12:6447. [PMID: 37892585 PMCID: PMC10607747 DOI: 10.3390/jcm12206447] [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: 08/25/2023] [Revised: 10/04/2023] [Accepted: 10/09/2023] [Indexed: 10/29/2023] Open
Abstract
Case studies of rare oncologic metastases are an important source of clinical data for health care professionals and researchers. While infrequent, the knowledge base and clinical recommendations derived from such cases aid in advancements in the field. As such, we aim to add five cases to the growing body of literature. The first two male patients, aged 69 and 73, were diagnosed with colon adenocarcinoma, suspected to be a second primary prostate carcinoma, following positron emission tomography-computer tomography (PET-CT). This suspicion was ruled out by prostatectomy and histopathological investigations, which instead found adenocarcinoma of colonic origin. The next two male patients, ages 63 and 68, were diagnosed, respectively, with metastatic pancreatic adenocarcinoma with cardiac metastases and metastatic melanoma with distant metastases to the pancreas. The final patient was a 73-year-old male diagnosed with metastatic breast cancer after a radiological investigation of suspected renal cell carcinoma.
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Affiliation(s)
- Walid Shalata
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
| | - Ashraf Abu Jama
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
| | - Amjad Abu Salman
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
- Cardiology Division, Soroka Medical Center, Beer Sheva 84105, Israel
| | - Mitchell Golosky
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
- Medical School for International Health and Sciences, Ben-Gurion University, Beer-Sheva 84105, Israel
| | - Adam Solomon
- Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva 84105, Israel (A.S.)
- Medical School for International Health and Sciences, Ben-Gurion University, Beer-Sheva 84105, Israel
| | - Omar Abu Saleh
- Department of Dermatology and Venereology, The Emek Medical Centre, Afula 18341, Israel
| | - Regina Michlin
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
| | - Sondos Shalata
- Nutrition Unit, Galilee Medical Center, Nahariya 22000, Israel;
| | - Abed Agbarya
- Department of Oncology, Bnai Zion Medical Center, Haifa 31048, Israel
| | - Alexander Yakobson
- The Legacy Heritage Cancer Center and Dr. Larry Norton Institute, Soroka Medical Center, Beer Sheva 84105, Israel; (A.A.J.)
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Lin J, Zhuo Y, Zhang Y, Liu R, Zhong W. Molecular predictors of metastasis in patients with prostate cancer. Expert Rev Mol Diagn 2023; 23:199-215. [PMID: 36860119 DOI: 10.1080/14737159.2023.2187289] [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: 03/03/2023]
Abstract
INTRODUCTION Prostate cancer is a serious threat to the health of older adults worldwide. The quality of life and survival time of patients sharply decline once metastasis occurs. Thus, early screening for prostate cancer is very advanced in developed countries. The detection methods used include Prostate-specific antigen (PSA) detection and digital rectal examination. However, the lack of universal access to early screening in some developing countries has resulted in an increased number of patients presenting with metastatic prostate cancer. In addition, the treatment methods for metastatic and localized prostate cancer are considerably different. In many patients, early-stage prostate cancer cells often metastasize due to delayed observation, negative PSA results, and delay in treatment time. Therefore, the identification of patients who are prone to metastasis is important for future clinical studies. AREAS COVERED this review introduced a large number of predictive molecules related to prostate cancer metastasis. These molecules involve the mutation and regulation of tumor cell genes, changes in the tumor microenvironment, and the liquid biopsy. EXPERT OPINION In next decade, PSMA PET/CT and liquid biopsy will be the excellent predicting tools, while 177 Lu- PSMA-RLT will be showed excellent anti-tumor efficacy in mPCa patients.
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Affiliation(s)
- Jundong Lin
- Department of Urology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Yangjia Zhuo
- Department of Urology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Yixun Zhang
- Department of Urology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Ren Liu
- Guangdong Key Laboratory of Clinical Molecular Medicine and Diagnostics, Guangzhou First People's Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
| | - Weide Zhong
- Department of Urology, The Second Affiliated Hospital, School of Medicine, South China University of Technology, Guangzhou, Guangdong, China
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Tunio MA, Agamy AM, Fenn N, Hanratty D, Williams NW. An unusual delayed rectal metastasis from prostate cancer masquerading as primary rectal cancer. Int J Surg Case Rep 2022; 100:107732. [PMID: 36252546 PMCID: PMC9574773 DOI: 10.1016/j.ijscr.2022.107732] [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: 09/10/2022] [Accepted: 10/07/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction and importance Rectal metastasis of prostate cancer origin is exceedingly rare. Its clinical presentation, endoscopic morphology, and histopathology are similar to primary rectal cancer. Misdiagnosis may lead to inappropriate treatment. Case presentation We report a case of a gentleman in his 80's with a history of treated prostate cancer T3aN0M0 with radical prostatectomy sixteen years ago. He presented with one-year complaints of altered bowel habits and weight loss. Physical and rectal examination was unremarkable. Colonoscopy manifested some inflammatory changes in the rectum. The pelvis magnetic resonance imaging (MRI) showed an abnormal posterior rectal wall thickening 2 cm above the anal canal. Biopsy confirmed poorly differentiated adenocarcinoma of prostate origin. The staging workup was negative for other distant metastasis. After a multidisciplinary decision, the patient was started on androgen deprivation therapy and given palliative radiotherapy to the rectum. Six weeks later, the patient was stable with mild radiation proctitis. Clinical discussion Management of rectal metastasis varies depending on the patient's choice, the extent of metastatic burden, symptoms, age, life expectancy, quality of life and comorbidities. While surgery remains the standard of care, other option including radiotherapy, hormonal therapy and chemotherapy has been documented in the literature with survival of few weeks to 2 years. Conclusion Delayed rectal metastasis of prostate cancer after radical prostatectomy is a rare entity. Its clinical presentation and endoscopic and histopathological findings of rectal metastasis are similar to primary colorectal cancer, making diagnosis more demanding. Rectum is a rare isolated site of metastasis from prostate cancer. Symptoms and endoscopic morphology of rectal metastasis are similar to primary rectal cancer. Prostate-specific antigen is not always raised in rectal metastasis. Emergent lower gastrointestinal symptoms in patients with a history of prostate cancer warrants a multidisciplinary approach to reach an accurate diagnosis and prompt treatment. Management of rectal metastasis depends on patient desire, the severity of symptoms, age, quality of life, life expectancy and comorbidities.
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Affiliation(s)
- Mutahar Ali Tunio
- Clinical Oncology, Swansea Bay University Health Board, Swansea, UK,Corresponding author.
| | | | - Neil Fenn
- Clinical Oncology, Swansea Bay University Health Board, Swansea, UK,Urology, Swansea Bay University Health Board, Swansea, UK
| | - Daniel Hanratty
- Colorectal Surgery, Swansea Bay University Health Board, Swansea, UK
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Singh SS, Singh RKR, Kumar N, Atrey H. Isolated Rectal Metastases from Locally Advanced Carcinoma Prostate Detected by 18F-PSMA-1007 PET/CT. World J Nucl Med 2022; 21:248-250. [PMID: 36060078 PMCID: PMC9436518 DOI: 10.1055/s-0042-1750440] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
Rectal involvement by prostate carcinoma is rare and isolated rectal metastases are even rarer with only a few cases having been reported in the literature. In our knowledge, no case of isolated rectal metastases diagnosed on prostate specific membrane antigen positron emission tomography/computed tomography has been reported to date. We present a case of a 66-year-old patient who presented with rectal bleeding and passage of urine from anal region and was diagnosed with carcinoma prostate infiltrating the rectum along with solitary rectal metastases.
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Affiliation(s)
| | | | - Narvesh Kumar
- Department of Nuclear Medicine, Apollomedics Hospital, Lucknow, Uttar Pradesh, India
| | - Harshvardhan Atrey
- Department of Medical Oncology, Apollomedics Hospital, Lucknow, Uttar Pradesh, India
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Hamada Y, Ikenoyama Y, Baba Y, Horiki N, Tanaka K. Solitary rectal metastasis of prostate cancer resembling primary colorectal cancer. JGH OPEN 2021; 5:1216-1217. [PMID: 34622011 PMCID: PMC8485405 DOI: 10.1002/jgh3.12637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Accepted: 08/04/2021] [Indexed: 11/13/2022]
Affiliation(s)
- Yasuhiko Hamada
- Department of Gastroenterology and Hepatology Mie University Hospital Tsu Japan
| | - Yohei Ikenoyama
- Department of Gastroenterology and Hepatology Mie University Hospital Tsu Japan
| | - Youichirou Baba
- Department of Pathology Suzuka Central General Hospital Suzuka Japan
| | | | - Kyosuke Tanaka
- Department of Endoscopy Mie University Hospital Tsu Japan
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Ryg U, Lilleby W, Hole KH, Lund-Iversen M, Switlyk MD. Local Recurrence of Prostate Cancer to the Intersphincteric Space: A Case Report. Urology 2020; 140:18-21. [PMID: 32199872 DOI: 10.1016/j.urology.2020.03.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2020] [Revised: 02/24/2020] [Accepted: 03/07/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Una Ryg
- Department of Radiology, Radiumhospitalet, Oslo University Hospital, Oslo, Norway
| | - Wolfgang Lilleby
- Department of Oncology, Radiumhospitalet, Oslo University Hospital, Oslo, Norway
| | - Knut H Hole
- Department of Radiology, Radiumhospitalet, Oslo University Hospital, Oslo, Norway
| | - Marius Lund-Iversen
- Department of Pathology, Radiumhospitalet, Oslo University Hospital, Oslo, Norway
| | - Marta D Switlyk
- Department of Radiology, Radiumhospitalet, Oslo University Hospital, Oslo, Norway.
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