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Intracranial treatment for solitary prostatic adenocarcinoma brain metastasis is curative
Thomas Sweets1, R Bruce Bracken, Eric J Geisler
1Division of Urology, Department of Surgery, University of Cincinnati, Cincinnati, Ohio 45267, USA.
Abstract:
Solitary metastasis to the brain from prostate cancer is rare. We present a young patient with a prostate-specific antigen value of 26 ng/dL and pathologic Gleason score 4 + 5 = 9 prostatic adenocarcinoma who developed a solitary cerebral metastasis 4 years after radical prostatectomy. With aggressive treatment involving resection of the solitary metastasis and use of local brachytherapy, the patient remains with an undetectable PSA level and without evidence of disease 5 years later. Our experience suggests that delayed solitary metastasis may be curable with treatment.
Insights
Solitary brain metastasis from prostate cancer is rare but potentially curable. Aggressive treatment, including surgery and brachytherapy, led to a complete recovery in a young patient with advanced prostate adenocarcinoma.
Area of Science:
- Oncology
- Neurology
Background:
- Prostate cancer can metastasize to the brain, though solitary brain metastasis is uncommon.
- Advanced prostate adenocarcinoma with a high Gleason score presents unique treatment challenges.
Observation:
- A young patient with Gleason score 9 prostatic adenocarcinoma developed a solitary brain metastasis 4 years post-prostatectomy.
- The patient presented with an elevated prostate-specific antigen (PSA) level of 26 ng/dL.
Findings:
- Aggressive treatment combining surgical resection of the metastasis and local brachytherapy was employed.
- The patient achieved undetectable PSA levels and remained disease-free for 5 years post-treatment.
Implications:
- Solitary, delayed brain metastases from prostate cancer may be curable with prompt and aggressive intervention.
- This case highlights the importance of considering unusual metastatic patterns in prostate cancer management.
