A 66-year-old man was referred to our hospital because of right leg pain. Computed tomography (CT) revealed multiple osteolytic changes. His serum prostate-specific antigen (PSA) level was increased to 77. 83 ng/ml at the time of hospitalization. A prostate biopsy was performed, and histological examination results indicated poorly differentiated adenocarcinoma. Under the diagnosis of multiple bone metastasis of prostate cancer, androgen deprivation therapy was started. However, 1 month later, the patient was confused and lost appetite. Brain CT image demonstrated brain metastasis, and magnetic resonance image showed hydrocephalus. Although the patient underwent ventricular drainage because of a depressed level of consciousness, he died of primary disease complicated by pneumonia 3 months after the first visit. Perioperative cerebrospinal fluid cytological examination revealed adenocarcinoma cells. Therefore, a diagnosis of carcinomatous meningitis caused by prostate cancer metastasis was made.
Hinyokika kiyo. Acta urologica Japonica. 2016 May [Epub]
Masatake Shinohara, Keisuke Kiba, Atsushi Yamada, Kinta Hatakeyama, Yasunobu Mita, Toshihisa Saka, Yoshihik Hirao
The Department of Urology, Osaka Gyoumeikan Hospital., The Department of Urology, Nara Hospital Kinki University Faculty of Medicine., The Department of Urology, Osaka Gyoumeikan Hospital., The Department of Diagnostic Pathology, Nara Medical University., The Department of Neurosurgery, Yamamoto Third Hospital., The Department of Urology, Osaka Gyoumeikan Hospital., The Department of Urology, Osaka Gyoumeikan Hospital.