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Prostatic meningeal carcinomatosis presenting as delirium tremens
1Veterans Affairs Medical Center, Minneapolis, MN 55417, USA.
Abstract:
We report an unusual case of prostatic carcinomatous meningitis and remind clinicians to maintain a high index of suspicion of meningeal involvement when patients with advanced prostatic cancer present with cerebral symptoms, back pain, or neurologic findings. The diagnosis may require repeated cytologic examinations of cerebrospinal fluid, and immunocytochemical stains should be considered to confirm a prostatic source if malignant cells are identified. Androgen ablative therapy may give prolonged remissions, especially in patients with previously untreated tumours.
Insights
Prostatic carcinomatous meningitis is rare but serious. Early diagnosis via cerebrospinal fluid analysis and prompt androgen ablative therapy can lead to prolonged remission in advanced prostate cancer patients.
Area of Science:
- Oncology
- Neurology
Background:
- Advanced prostate cancer can metastasize to various organs.
- Meningeal carcinomatosis is a rare but severe complication of advanced cancers.
Observation:
- A case of prostatic carcinomatous meningitis presented with cerebral symptoms, back pain, and neurologic findings.
- Diagnosis required repeated cerebrospinal fluid cytology and immunocytochemical stains.
Findings:
- Malignant cells of prostatic origin were identified in the cerebrospinal fluid.
- Androgen ablative therapy resulted in prolonged remission.
Implications:
- Clinicians should suspect meningeal involvement in advanced prostate cancer patients with neurological symptoms.
- Immunocytochemistry is crucial for confirming the prostatic origin of malignant cells.
- Androgen ablative therapy is a potentially effective treatment for prostatic carcinomatous meningitis.