Dysphasia: metastatic prostate cancer to the leptomeninges: a case report.

Publisher: BioMed Central Country of Publication: England NLM ID: 101293382 Publication Model: Electronic Cited Medium: Internet ISSN: 1752-1947 (Electronic) Linking ISSN: 17521947 NLM ISO Abbreviation: J Med Case Rep Subsets: MEDLINE

Original Publication: [London] : BioMed Central, [2007-

Aphasia*/etiology ; Meningeal Neoplasms*/secondary ; Prostatic Neoplasms, Castration-Resistant*/pathology; Humans ; Male ; Middle Aged ; Fatal Outcome ; Magnetic Resonance Imaging ; Bone Neoplasms/secondary ; Prostatic Neoplasms/pathology

Background: Leptomeningeal metastasis occurs in 5% of patients with prostate cancer and indicates a very poor prognosis.
Case Presentation: A 60-year-old Caucasian male patient diagnosed with metastatic castration-resistant prostate cancer with sclerotic bone metastases and soft tissue metastases underwent multiple courses of chemotherapy and hormone therapy. The diagnosis of prostate cancer is based on elevated prostate-specific antigen levels and tissue biopsy. He subsequently presented with expressive aphasia. Nonspecific, diffuse irregular dural/pachymeningeal thickening enhancement was noted on magnetic resonance imaging. Upon evaluation by neurology, electroencephalogram was negative for an epileptiform correlate. The workup included a lumbar puncture to rule out infectious etiology. The patient's neurological status stabilized, and he was discharged home with a plan for continued therapy with abiraterone and prednisone. Due to advanced malignancy, the patient enrolled in hospice and died 3 weeks after hospital discharge.
Conclusions: Central nervous system metastasis occurs very rarely in prostate cancer. With the increase in life expectancy and advances in oncologic therapy for prostate cancer, physicians should be aware of and consider central nervous system metastasis in men aged 50 years and above.
(© 2024. The Author(s).)

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Keywords: CNS metastasis; Metastatic castration-resistant prostate cancer; Prostate cancer

Date Created: 20241031 Date Completed: 20241031 Latest Revision: 20241102

20250114

PMC11526645

10.1186/s13256-024-04840-5

39478563