Intracranial metastases from prostate adenocarcinoma are very unusual, and initial presentation with symptomatic brain involvement is especially rare. We describe a 65-year-old male who presented with blurred vision and was found to have abducent nerve involvement and high-grade metastatic prostate cancer. Computed tomography of his head revealed a destructive lesion involving the clivus. He was started on hormonal treatment and his visual symptoms improved. Repeat scans after 6 months revealed resolution of the clivus lesion. Prostate cancer can occasionally present with neurologic manifestations, predominantly due to metastatic involvement of the skull bone. Awareness of this possibility could lead to accurate diagnosis. Initiation of appropriate therapy can successfully reverse the neurologic deficits.
Ashish Bhargava,1 Hussein Aoun,2 Mehsati Herawi,3 Ulka Vaishampayan1
1 Department of Internal Medicine, Wayne State University, Karmanos Cancer Institute, Detroit Michigan, USA
2Department of Radiology, Wayne State University, Karmanos Cancer Institute, Detroit Michigan, USA
3 Department of Pathology, Wayne State University, Karmanos Cancer Institute, Detroit Michigan, USA
Submitted July 8, 2010 - Accepted for Publication September 15, 2010
KEYWORDS: Prostate adenocarcinoma; Brain metastasis; Hormonal therapy
CORRESPONDENCE: Ashish Bhargava, MD, Department of Internal Medicine, 2E University Health Center, 4201 St. Antoine, Detroit, MI 48201, USA ().
CITATION: UroToday Int J. 2010 Oct;3(5). doi:10.3834/uij.1944-5784.2010.10.11
ABBREVIATIONS AND ACRONYMS: CT, computed tomography; MRI, magnetic resonance image; PSA, prostate-specific antigen.