Brain metastasis from prostate cancer with neurologic symptoms as the first sign: a case report

Prostate cancer most commonly metastasizes to bones and lymph nodes; visceral metastases are uncommon. Central nervous system involvement is exceedingly rare. Here, we report a case of prostate cancer with brain metastasis initially presenting as a lesion occupying the sellar and suprasellar regions and discuss its management.

An 80-year-old male presented with diplopia for two months. Brain MRI showed an occupying lesion in the sellar and suprasellar regions. He also reported urinary difficulty and constipation. Laboratory tests showed elevated TPSA (367.000 ng/mL) and FPSA (40.300 ng/mL) levels. Imaging supported prostate cancer with a suprasellar metastatic lesion. Transurethral prostate resection confirmed prostate adenocarcinoma. He was diagnosed with mHSPC (T4N1M1) and received endocrine therapy.

Brain metastasis from prostate cancer is rare. This case demonstrated a significant reduction in both primary and metastatic lesions following ADT-based endocrine therapy, with no significant adverse effects.