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

Published online by Cambridge University Press:  02 December 2014

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

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Background:

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

Case report:

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

Results:

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

Conclusion:

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

Résumé:

RÉSUMÉ:Introduction:

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

Présentation de cas:

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

Résultats:

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

Conclusion:

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

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

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