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Skrobisz K, Miszewski K, Miszewska L, Bieńkowski M, Matuszewski M, Studniarek M. Pleural Metastasis as an Initial Presentation of Prostate Cancer: Case Report and Literature Review. Diagnostics (Basel) 2025; 15:666. [PMID: 40150008 PMCID: PMC11940987 DOI: 10.3390/diagnostics15060666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2025] [Revised: 02/23/2025] [Accepted: 03/05/2025] [Indexed: 03/29/2025] Open
Abstract
Background and Clinical Significance: Prostate cancer (PCa) is among the most commonly diagnosed malignancies in men worldwide. While bone and lymph nodes are the most frequent metastatic sites, prostate cancer cells have the potential to spread to virtually any organ, including the pleura, which is an exceedingly rare initial site of presentation that can mimic mesothelioma or primary lung cancer. Case Presentation: We describe a 77-year-old man who presented with exertional dyspnea and intermittent cough, initially suggesting a cardiopulmonary etiology. Imaging revealed multiple pleural nodules and an extensive right-sided pleural effusion. Despite a borderline serum prostate-specific antigen (PSA) level of 2.91 ng/mL, histopathology and immunohistochemistry of pleural biopsies confirmed metastatic prostate adenocarcinoma. Subsequent imaging identified a PIRADS 5 lesion in the prostate, and a biopsy confirmed ISUP Grade Group 5 disease (Gleason score 4 + 5 = 9). A bone scan showed no skeletal metastases, and a contrast-enhanced CT of the abdomen found no additional metastatic lesions. The patient was started on androgen deprivation therapy followed by abiraterone. This case underscores the diagnostic challenge posed by atypical metastatic presentations of prostate cancer. Low or moderately elevated PSA can obscure suspicion of prostate origin, especially with pleural-based lesions suggestive of mesothelioma. Immunohistochemical markers, including androgen receptors, AMACR, and Prostein, are critical for accurate diagnosis. Conclusions: Clinicians must maintain a high index of suspicion for prostate cancer in older men with unexplained pleural effusions, nodules, or masses, even with low-normal PSA levels. Early recognition and prompt treatment can improve outcomes, despite the rarity and aggressiveness of pleural metastases.
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Affiliation(s)
- Katarzyna Skrobisz
- Department of Radiology, Medical University of Gdańsk, 17 Smoluchowskiego St., 80-214 Gdańsk, Poland; (K.S.)
| | - Kevin Miszewski
- Department of Urology, Medical University of Gdańsk, 17 Smoluchowskiego St., 80-214 Gdańsk, Poland
| | - Laura Miszewska
- Faculty of Medicine, Medical University of Gdańsk, 17 Smoluchowskiego St., 80-214 Gdańsk, Poland
| | - Michał Bieńkowski
- Department of Pathology, Medical University of Gdańsk, 17 Smoluchowskiego St., 80-214 Gdańsk, Poland
| | - Marcin Matuszewski
- Department of Urology, Medical University of Gdańsk, 17 Smoluchowskiego St., 80-214 Gdańsk, Poland
| | - Michał Studniarek
- Department of Radiology, Medical University of Gdańsk, 17 Smoluchowskiego St., 80-214 Gdańsk, Poland; (K.S.)
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Muglia VF, Laschena L, Pecoraro M, de Lion Gouvea G, Colli LM, Panebianco V. Imaging assessment of prostate cancer recurrence: advances in detection of local and systemic relapse. Abdom Radiol (NY) 2025; 50:807-826. [PMID: 39254707 DOI: 10.1007/s00261-024-04412-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/25/2024] [Accepted: 05/27/2024] [Indexed: 09/11/2024]
Abstract
Prostate cancer (PCa) relapse, defined either by persistent PSA levels (after RP) or biochemical recurrence (BCR), is a common occurrence. The imaging evaluation of patients experiencing PCa relapse has undergone significant advancements in the past decade, notably with the introduction of new Positron Emission Tomography (PET) tracers such as Prostate-specific membrane antigen (PSMA), and the progress in functional Magnetic Resonance Imaging (MRI). This article will explore the role of traditional imaging, the evolution of MRI towards the development of the Prostate Magnetic Resonance Imaging for Local Recurrence Reporting (PI-RR) scoring system, and how next-generation imaging is enhancing diagnostic accuracy in the setting of PCa relapse, which is essential for adopting personalized strategies that may ultimately impact outcomes.
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Affiliation(s)
- Valdair Francisco Muglia
- Department of Medical Images, Oncology and Hematology, Ribeirao Preto Medical School, University of Sao Paulo, Hospital Clinicas Ribeirao Preto - Av. Bandeirantes 3900. Campus Monte Alegre -USP, Sao Paulo, 14049-900, Brazil.
| | - Ludovica Laschena
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University, Rome, Italy
| | - Martina Pecoraro
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University, Rome, Italy
| | - Gabriel de Lion Gouvea
- Department of Medical Images, Oncology and Hematology, Ribeirao Preto Medical School, University of Sao Paulo, Hospital Clinicas Ribeirao Preto - Av. Bandeirantes 3900. Campus Monte Alegre -USP, Sao Paulo, 14049-900, Brazil
| | - Leandro Machado Colli
- Department of Medical Images, Oncology and Hematology, Ribeirao Preto Medical School, University of Sao Paulo, Hospital Clinicas Ribeirao Preto - Av. Bandeirantes 3900. Campus Monte Alegre -USP, Sao Paulo, 14049-900, Brazil
| | - Valeria Panebianco
- Department of Radiological Sciences, Oncology and Pathology, Sapienza University, Rome, Italy
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3
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Barali D, Gul A, Ocak B, Ozer M. Isolated Bilateral Adrenal Metastasis in Castration-Resistant Prostate Cancer: A Case Report and Literature Review. Cureus 2024; 16:e75985. [PMID: 39834965 PMCID: PMC11743725 DOI: 10.7759/cureus.75985] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/18/2024] [Indexed: 01/22/2025] Open
Abstract
Prostate cancer frequently metastasizes to regional lymph nodes and bones, but metastasis to the adrenal glands remains rare, particularly in isolation. This case report presents an unusual instance of bilateral adrenal metastasis in a patient with castration-resistant prostate cancer. This case emphasizes the clinical relevance of adrenal metastasis in castration-resistant prostate cancer, highlighting the potential role of aggressive treatment strategies such as metastasectomy in isolated adrenal involvement, aiming to contribute to the limited literature on this rare metastatic pattern. Further studies are warranted to explore the therapeutic impact of adrenalectomy in similar cases, potentially enhancing progression-free survival in selected patients.
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Affiliation(s)
- Deniz Barali
- Urology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, TUR
| | - Abdullah Gul
- Urology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, TUR
| | - Birol Ocak
- Medical Oncology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, TUR
| | - Mehmet Ozer
- Pathology, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, TUR
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Edamadaka Y, Parghane RV, Basu S. Portal Venous Tumor Thrombosis and Visceral Organ Metastasis without Skeletal Involvement in mCRPC: Adverse Prognostic Indicators on Dual Tracer PET/CT and Clinical Outcome after 177 Lu-PSMA-617 PRLT and Cabazitaxel Therapy. World J Nucl Med 2024; 23:302-306. [PMID: 39677344 PMCID: PMC11637644 DOI: 10.1055/s-0044-1788736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2024] Open
Abstract
Prostate cancer involving visceral organs are occurrences in the later disease course, usually following regional nodal and skeletal involvement, and are refractory to conventional treatment. A 61-year-old male patient presented with locally advanced disease at presentation, which progressed on androgen deprivation therapy and systemic therapy with involvement of the visceral organs (lungs and liver). Portal venous tumor thrombosis involving the right and main branch was also observed on contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI), which showed intense uptake on 68 Ga-labeled prostate-specific membrane antigen positron emission tomography/computed tomography ( 68 Ga-PSMA-11 PET/CT) and 18 F-fluorodeoxyglucose PET/CT ( 18 F-FDG-PET/CT). Post- 177 Lu-PSMA-617 radioligand therapy (PRLT) showed mixed response on tumor marker and imaging analysis with survival of 6 months after 177 Lu-PSMA radioligand therapy. The high Gleason score, visceral organ metastasis, and increased metabolic activity on FDG were the adverse prognostic factors in the described patient.
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Affiliation(s)
- Yeshwanth Edamadaka
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - Rahul V. Parghane
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
| | - Sandip Basu
- Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai, India
- Homi Bhabha National Institute, Mumbai, India
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5
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Glen H, Bahl A, Fleure L, Clarke N, Jain S, Kalsi T, Khoo V, Mobeen J. A modified Delphi consensus regarding the clinical utility of triplet therapy in patients with metastatic hormone-sensitive prostate cancer patients in the UK. BMJ Open 2024; 14:e090013. [PMID: 39609017 PMCID: PMC11603693 DOI: 10.1136/bmjopen-2024-090013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2024] [Accepted: 10/22/2024] [Indexed: 11/30/2024] Open
Abstract
OBJECTIVES This study aimed to determine the clinical utility of the androgen deprivation therapy (ADT)+docetaxel (DOCE)+androgen receptor-targeted agent (ARTA) triplet therapy in patients with metastatic hormone-sensitive prostate cancer (mHSPC) in the UK. DESIGN A modified Delphi method. A steering group of eight UK healthcare professionals experienced in prostate cancer care discussed treatment challenges, developing 39 consensus statements across four topics. Agreement with the statements was tested with a broader panel of professionals within this therapeutic area in the UK through an anonymous survey, using a four-point Likert scale. This was distributed by the steering group members and an independent third party. Following the survey, the steering group convened to discuss the results and formulate recommendations. SETTING The steering group convened online for discussions. The survey was distributed via email by the clinicians and the independent third party. PARTICIPANTS Healthcare professionals involved in the provision of prostate cancer care, working in relevant professional roles (oncology, urology or geriatric consultant, oncology nurse specialist, and hospital pharmacist) within the UK. No patients or members of the public were involved within the study. INTERVENTIONS None. PRIMARY AND SECONDARY OUTCOME MEASURES Consensus was defined as high (≥75% agreement) and very high (≥90% agreement). RESULTS Responses were received from 120 healthcare professionals, including oncologists (n=73), urologists (n=16), geriatricians (n=15), nurse specialists (n=11) and hospital pharmacists (n=5). Consensus was reached for 37 out of 39 (95%) statements, and 27/39 (69%) statements achieved very high agreement ≥90%. Consensus was not reached for 2/39 (5%) statements. CONCLUSIONS Based on the consensus observed, the steering group developed a set of recommendations for the clinical utility of ADT+DOCE+ARTA in treating patients with mHSPC in the UK. Following these recommendations enables clinicians to identify appropriate patients with mHSPC for triplet treatment, thereby improving patients' outcomes.
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Affiliation(s)
- Hilary Glen
- Beatson West of Scotland Cancer Centre, Glasgow, UK
| | - Amit Bahl
- University Hospitals Bristol NHS Foundation Trust, Bristol, UK
| | - Louisa Fleure
- Guy's and Saint Thomas' NHS Foundation Trust, London, UK
| | - Noel Clarke
- Clinical Effectiveness Unit, Royal College of Surgeons of England, London, UK
- The Christie NHS Foundation Trust, Manchester, Manchester, UK
| | | | - Tania Kalsi
- Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Vincent Khoo
- Department of Oncology, Royal Marsden NHS Foundation Trust, London, UK
| | - Junaid Mobeen
- Nottingham University Hospitals NHS Trust, Nottingham, UK
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Okidi R, Hajarah N, Mukurasi D, Obonyo E, Makai E, Lajul D, Odongkara M, Bamutorana T, Omagino BA, Okello I. Prostatic duct adenocarcinoma-A challenging variant of prostate cancer in a low-resource setting. Clin Case Rep 2024; 12:e9557. [PMID: 39502122 PMCID: PMC11534637 DOI: 10.1002/ccr3.9557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2024] [Revised: 09/15/2024] [Accepted: 10/11/2024] [Indexed: 11/08/2024] Open
Abstract
This case emphasizes the challenges in diagnosing and treating Prostatic Duct Adenocarcinoma, especially in resource-limited settings. Early and accurate diagnosis is crucial for better patient outcomes, but limited access to advanced diagnostics and specialized treatments significantly hinders the effective management of this aggressive form of prostate cancer.
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Affiliation(s)
- Ronald Okidi
- Department of SurgeryLacor HospitalGuluUganda
- Faculty of Medicine, Department of SurgeryGulu UniversityGuluUganda
- Central and Southern AfricaCollege of Surgeons of EastArushaTanzania
| | | | - Derrick Mukurasi
- Department of SurgeryLacor HospitalGuluUganda
- Central and Southern AfricaCollege of Surgeons of EastArushaTanzania
| | - Emmanuel Obonyo
- Department of SurgeryLacor HospitalGuluUganda
- Central and Southern AfricaCollege of Surgeons of EastArushaTanzania
- Kalongo, Department of SurgeryDr Ambrosoli HospitalKalongoUganda
| | | | | | | | | | | | - Isaac Okello
- Central and Southern AfricaCollege of Surgeons of EastArushaTanzania
- Medical Teams International (MTI)Lacor HospitalGuluUganda
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Zemanek M, Powers JC, Westbrook K, Dester E, Smith R, Qazi T. Rare Metastasis of Prostate Cancer in a Man With Ulcerative Colitis After Creation of an Ileal Pouch. ACG Case Rep J 2024; 11:e01552. [PMID: 39530012 PMCID: PMC11554348 DOI: 10.14309/crj.0000000000001552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2024] [Accepted: 09/27/2024] [Indexed: 11/16/2024] Open
Abstract
Prostate cancer is one of the most common globally diagnosed cancers in men. It most frequently metastasizes to bones, lymph nodes, lungs, or the liver. There are limited data investigating the impact of prostate cancer on patients who have undergone ileal pouch-anal anastomosis. We explore the case and the diagnosis of a 68-year-old man with prostate adenocarcinoma that metastasized to the ileal pouch and ultimately required pouch explant. In addition, we discuss the challenges associated with screening and treating prostate cancer in patients with ileal pouch-anal anastomosis.
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Affiliation(s)
- Mark Zemanek
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH
| | - Joseph Carter Powers
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| | | | - Emma Dester
- Cleveland Clinic Lerner College of Medicine of Case Western Reserve University, Cleveland, OH
| | - Riley Smith
- Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, OH
| | - Taha Qazi
- Digestive Disease and Surgery Institute, Cleveland Clinic, Cleveland, OH
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8
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Zhang Y, Chen J, Xu L, Hu X, Zeng H, Liu Z. Case report: Synchronous prostate cancer and renal cell carcinoma with prostate cancer-origin metastases to adrenal and renal hilar lymph nodes. Front Oncol 2024; 14:1412067. [PMID: 39435284 PMCID: PMC11491287 DOI: 10.3389/fonc.2024.1412067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Accepted: 09/18/2024] [Indexed: 10/23/2024] Open
Abstract
Background Synchronous occurrence of prostate cancer (PCa) and renal cell carcinoma (RCC) is uncommon. RCC has a higher tendency to metastasize to the adrenal glands, renal hilar, and retroperitoneal lymph nodes compared to PCa. To date, there are no documented cases existing where metastatic tumors in these regions, observed in patients concurrently with PCa and RCC, have originated from the PCa rather than the RCC. Case presentation In this case report, we described a 67-year-old male presented with dysuria for two months and left lower extremity edema for three days. Percutaneous biopsies revealed synchronous primary RCC and PCa. However, the origin of the metastatic tumors, especially those involving the adrenal glands, renal hilum, and retroperitoneal regions, remained undetermined. Subsequent surgical procedures identified that the metastatic lesions originated from the PCa, while the RCC was localized. Ultimately, the patient with metastatic hormone-sensitive prostate cancer (mHSPC) received combination therapy with rezvilutamide and goserelin, which resulted in a satisfactory treatment response. Conclusion In patients with concurrent PCa and RCC, metastatic lesions in the adrenal glands, renal hilar, and retroperitoneal lymph nodes may also originate from the PCa. Accurate identification of the primary tumor and proper staging are critical for the appropriate management of patients with multiple primary malignancies with concurrent metastases.
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Affiliation(s)
- Yaowen Zhang
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Junru Chen
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Lijing Xu
- Department of Urology, West China Xiamen Hospital, Sichuan University, Xiamen, China
| | - Xu Hu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Hao Zeng
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
| | - Zhenhua Liu
- Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, China
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9
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De Jesus GNC, Pereira V, Karak P, Shearier E. A single-center retrospective review of metastatic prostate cancer on PSMA position emission tomography/computed tomography: Beyond lymph nodes and bones. Prostate 2024. [PMID: 39295117 DOI: 10.1002/pros.24795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/22/2024] [Revised: 09/05/2024] [Accepted: 09/09/2024] [Indexed: 09/21/2024]
Abstract
BACKGROUND Prostate-specific membrane antigen (PSMA) Positron emission tomography/computed tomography (PET/CT) has become a crucial imaging modality for the staging of patients with prostate cancer. The purpose of this study is to retrospectively determine the frequency, anatomical distribution, and clinical-pathologic correlates of extra-nodal and extra-osseous metastatic prostate cancer detected on PSMA PET/CT. METHODS All available 650 PSMA PET/CT performed in patients with biopsy-proved prostate cancer in our institution between September 2021 and December 2023 were reviewed for the presence of extra-nodal and extra-osseous metastatic disease (M1C disease). Thirty-four patients with M1C disease were identified. RESULTS The most frequent sites of visceral/soft tissue metastases were the lungs (58.8%), liver (23.5%) and adrenal glands (20.6%). 75% of patients with lung metastases detected on PSMA PET/CT had concurrent intrathoracic lymph node involvement. A higher frequency of patients with M1C disease (55.9%) had a high Gleason score. The median prostate-specific antigen (PSA) level at the time of the PSMA scan was 20.16 ng/mL. There was a statistically significant association between PSA level and osseous disease (p = 0.004), as well as PSA level and nodal disease (p = 0.008). While a large number of patients had concurrent osseous and nodal disease (82.4% and 79.4%, respectively), no visceral/soft tissue sites demonstrated a significant association with the presence of osseous or nodal involvement. CONCLUSIONS Given the increasing utilization of PSMA PET/CT, increased knowledge of the location and pattern of distribution of visceral/soft tissue metastatic sites is crucial not only for staging but also to better understand patterns of therapeutic response. We identified the lungs, liver and adrenal glands as the most common visceral/soft tissue metastatic sites from prostate cancer. We found that higher PSA levels at the time of PSMA PET/CT imaging were positively associated with concurrent osseous and nodal involvement.
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Affiliation(s)
- Gabriela N C De Jesus
- Department of Radiology and Biomedical Imaging, Yale New Haven Hospital, New Haven, Connecticut, USA
| | - Veronica Pereira
- Department of Radiology, Section of Nuclear Medicine, Hartford Hospital, Hartford, Connecticut, USA
| | - Prasanta Karak
- Department of Radiology, Section of Nuclear Medicine, Hartford Hospital, Hartford, Connecticut, USA
| | - Emily Shearier
- Department of Radiology, Clinical Research Center, Hartford Hospital, Hartford, Connecticut, USA
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10
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Ahmed ME, Mahmoud AM, Reitano G, Zeina W, Lehner K, Day CA, Riaz I, Childs DS, Orme JJ, Tuba Kendi A, Johnson GB, Jeffrey Karnes R, Kwon ED, Andrews JR. Survival Patterns Based on First-site-specific Visceral Metastatic Prostate Cancer: Are Outcomes of Visceral Metastases the Same? EUR UROL SUPPL 2024; 66:38-45. [PMID: 39040620 PMCID: PMC11260861 DOI: 10.1016/j.euros.2024.06.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/11/2024] [Indexed: 07/24/2024] Open
Abstract
Background and objective Visceral metastatic disease in prostate cancer patients conveys a poor prognosis. Using advanced imaging techniques, studies have demonstrated increasing detection rates of visceral metastasis. Visceral metastases are now seen in up to 30-60% of prostate cancer patients. Survival patterns of site-specific visceral metastasis are described poorly in the literature. Here, we sought to investigate survival patterns in prostate cancer patients according to their first detected site of visceral metastasis. Methods Retrospectively, we identified 203 prostate cancer patients with visceral metastases from the Mayo Clinic Advanced Prostate Cancer Registry. Patients were divided into three groups according to the first site of visceral metastases detected: lung, brain, or liver. Visceral metastases were detected primarily on either metabolic imaging (C-11 choline) or prostate-specific membrane antigen positron emission tomography computed tomography (CT) scan. Confirmation of visceral metastasis diagnosis was established with either biopsy when feasible or focused conventional imaging, including focused CT or magnetic resonance imaging. Overall survival and cancer-specific survival were estimated using the Kaplan-Meier method. Univariate and multivariate Cox regression model was conducted to assess different variables that affect overall and cancer-specific survival. Key findings and limitations Over a median (interquartile range) follow-up duration of 16.2 (3.9-49.8) mo, the overall and cancer-specific survival of the entire cohort suggests better survival patterns in patients with first-site lung metastases than in patients with first-site brain or liver metastases (p < 0.0001). In univariate and multivariate analyses of factors impacting patients' overall and cancer-specific survival, a high prostate-specific antigen level at diagnosis of visceral metastasis, concomitant bone and lymph node disease, and more than four visceral metastases were associated with poor overall and cancer-specific survival (p < 0.05). On the contrary, first-site lung metastasis was associated with improved overall and cancer-specific survival, compared with first-site liver and brain metastases (p < 0.001). Conclusions and clinical implications These data suggest that prostate cancer patients with visceral metastatic disease have varying survival patterns according to first-site detected visceral metastasis. In our cohort, patients with first-site lung metastasis demonstrated better survival outcomes than patients with first-site brain or liver metastasis. Patient summary Our study explored the survival outcomes among patients with visceral metastatic prostate cancer employing cutting-edge imaging methods. Prostate cancer patients with metastases to different organs have different survival rates. Patients with cancer spreading to the lungs first showed better survival than those with cancer spreading to the brain or liver first.
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Affiliation(s)
| | | | | | - Wael Zeina
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - Kelly Lehner
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - Carter A. Day
- Department of Urology, Mayo Clinic, Rochester, MN, USA
| | - Irbaz Riaz
- Department of Medical Oncology, Mayo Clinic Arizona, Phoenix, AZ, USA
| | | | - Jacob J. Orme
- Department of Medical Oncology, Mayo Clinic, Rochester, MN, USA
| | - A. Tuba Kendi
- Department of Radiology, Division of Nuclear Medicine, Mayo Clinic, Rochester, MN, USA
| | - Geoffrey B. Johnson
- Department of Radiology, Division of Nuclear Medicine, Mayo Clinic, Rochester, MN, USA
| | | | | | - Jack R. Andrews
- Department of Urology, Mayo Clinic Arizona, Phoenix, AZ, USA
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11
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Üstün F, Günay BÖ, Ustabaşıoğlu FE, Korkmaz S. The Role of 68 Ga PSMA Imaging in Evaluating Adrenal Lesions in Prostate Cancer Patients. World J Nucl Med 2024; 23:103-109. [PMID: 38933065 PMCID: PMC11199028 DOI: 10.1055/s-0044-1786012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/28/2024] Open
Abstract
Objectives Gallium-68 prostate-specific membrane antigen ( 68 Ga-PSMA) imaging is valuable for staging because an accurate diagnosis, metastatic or nonmetastatic for prostate cancer patients, is required for deciding to treatment approaches and prognostic assessment. The aim of this study was primarily to distinguish between benign and metastatic adrenal gland lesions detected during 68 Ga-PSMA positron emission tomography (PET)/CT imaging, to evaluate the presence of factors predicting its development, and then to determine the life expectancy of patients with metastatic adrenal lesions. Materials and Methods We performed a database search for PET/CT records generated from June 2016 to February 2021 for "adrenal gland" in report for patients who underwent 68 Ga-PSMA examination with prostate cancer patients. Results Twenty-three patients (10 benign and 13 metastatic) were included in this study. The total prostate-specific antigen, adrenal gland size, adrenal gland density, and maximum standardized uptake (SUVmax) values are significantly different between groups ( p < 0.05). On receiver operating characteristic curve analysis, the SUVmax cutoff value > 6.8 provided both sensitivity and specificity of 100%. However, with 29 mm as the adrenal gland size cutoff and 21.2 as Hounsfield unit, the sensitivity and specificity were 56.2 and 92.3%, and 93.8 and 92.3%, respectively. The survival of the benign and metastatic groups was compared and a statistically significant difference was found ( p = 0.006). The presence of pelvic lymph nodes was statistically negatively affected the surveillance between the groups. Conclusion The presence of atypical metastases such as adrenal gland is not insignificant in prostate cancer patients. Because of this degree of impact on patient management, accurate staging by imaging with 68 Ga-PSMA should be an integral part of prostate cancer management.
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Affiliation(s)
- Funda Üstün
- Department of Nuclear Medicine, Faculty of Medicine, Trakya University, Edirne, Türkiye
| | - Büşra Özdemir Günay
- Department of Nuclear Medicine, Faculty of Medicine, Trakya University, Edirne, Türkiye
| | | | - Selçuk Korkmaz
- Department of Biostatistics, Faculty of Medicine, Trakya University, Edirne, Türkiye
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12
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Oyortey MA, Adanu KK, Ali MA. The effect of unusual presentation on delayed diagnosis of prostate cancer: a case series. J Med Case Rep 2024; 18:256. [PMID: 38773554 PMCID: PMC11110205 DOI: 10.1186/s13256-024-04543-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 04/03/2024] [Indexed: 05/24/2024] Open
Abstract
BACKGROUND Early diagnosis of prostate cancer is key to achieving a cure and its proper management leads to a good prognosis. In Ghana a large percentage of patients present with advanced disease and unusual presentations in these patients result in greater delay in the diagnosis thus worsening the outcomes. CASE PRESENTATION We present three African males with advanced prostate cancer who had delayed diagnosis. The first patient, a 64 year old male presented with ascites of 2 years duration with weight loss and no lower urinary tract symptoms, the second, a 69 year old man with end stage renal failure of 6 months duration and was receiving dialysis, the third case, an 87 year old man was managed for pulmonary tuberculosis after he presented with chronic cough and lower urinary tract symptoms. All patients eventually had a prostate specific antigen done which were elevated. Further investigations including prostate biopsies, abdominopelvic CT scans for case 1, abdominopelvic ultrasound, prostate biopsies and blood urea and electrolytes for case 2, prostate biopsies, chest and lumbosacral showed a diagnosis of metastatic prostate carcinoma, and all patients were managed with androgen deprivation. The second patient received additional radiotherapy. CONCLUSION A lack of knowledge of prostate cancer symptoms including unusual symptoms, can result in delayed diagnosis especially in regions of the world where a large number of patients present with advanced disease.
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13
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Yu C, Zong H, Chen Y, Zhou Y, Liu X, Lin Y, Li J, Zheng X, Min H, Shen B. PCAO2: an ontology for integration of prostate cancer associated genotypic, phenotypic and lifestyle data. Brief Bioinform 2024; 25:bbae136. [PMID: 38557678 PMCID: PMC10982949 DOI: 10.1093/bib/bbae136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Revised: 12/19/2023] [Accepted: 03/07/2024] [Indexed: 04/04/2024] Open
Abstract
Disease ontologies facilitate the semantic organization and representation of domain-specific knowledge. In the case of prostate cancer (PCa), large volumes of research results and clinical data have been accumulated and needed to be standardized for sharing and translational researches. A formal representation of PCa-associated knowledge will be essential to the diverse data standardization, data sharing and the future knowledge graph extraction, deep phenotyping and explainable artificial intelligence developing. In this study, we constructed an updated PCa ontology (PCAO2) based on the ontology development life cycle. An online information retrieval system was designed to ensure the usability of the ontology. The PCAO2 with a subclass-based taxonomic hierarchy covers the major biomedical concepts for PCa-associated genotypic, phenotypic and lifestyle data. The current version of the PCAO2 contains 633 concepts organized under three biomedical viewpoints, namely, epidemiology, diagnosis and treatment. These concepts are enriched by the addition of definition, synonym, relationship and reference. For the precision diagnosis and treatment, the PCa-associated genes and lifestyles are integrated in the viewpoint of epidemiological aspects of PCa. PCAO2 provides a standardized and systematized semantic framework for studying large amounts of heterogeneous PCa data and knowledge, which can be further, edited and enriched by the scientific community. The PCAO2 is freely available at https://bioportal.bioontology.org/ontologies/PCAO, http://pcaontology.net/ and http://pcaontology.net/mobile/.
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Affiliation(s)
- Chunjiang Yu
- Department of Urology and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
- School of Artificial Intelligence, Suzhou Industrial Park Institute of Services Outsourcing, Suzhou, 215123, China
- Center for Systems Biology, Soochow University, Suzhou, 215006, China
| | - Hui Zong
- Department of Urology and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yalan Chen
- Department of Urology and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
- Center for Systems Biology, Soochow University, Suzhou, 215006, China
- Department of Medical Informatics, School of Medicine, Nantong University, Nantong, 226001, China
| | - Yibin Zhou
- Department of Urology, The Second Affiliated Hospital of Soochow University, Suzhou, 215011, China
| | - Xingyun Liu
- Department of Urology and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Yuxin Lin
- Department of Urology, The First Affiliated Hospital of Soochow University, Suzhou, 215000, China
| | - Jiakun Li
- Department of Urology and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Xiaonan Zheng
- Department of Urology and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
| | - Hua Min
- Department of Health Administration and Policy, George Mason University, Fairfax, VA, USA
| | - Bairong Shen
- Department of Urology and Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, China
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14
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Zahran M, Larios H, Rosales V, Coulson A. Unilateral tongue atrophy as the initial clinical manifestation in a patient with prostate cancer. Clin Case Rep 2024; 12:e8615. [PMID: 38464579 PMCID: PMC10920314 DOI: 10.1002/ccr3.8615] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Revised: 01/21/2024] [Accepted: 02/12/2024] [Indexed: 03/12/2024] Open
Abstract
Key Clinical Message Unilateral tongue atrophy can be a rare and crucial early indicator of metastatic prostate cancer, highlighting the need for vigilant monitoring in clinical assessments. This case underscores the importance of considering cranial nerve involvement, especially the twelfth, for timely intervention and comprehensive patient care. Abstract Prostate cancer, ranking among the most prevalent cancers, often manifests with skeletal metastases. Cranial nerve involvement, particularly the twelfth cranial nerve (XII), as an initial presentation is exceptionally rare. This case report outlines a unique instance of unilateral tongue atrophy as the primary clinical manifestation in a patient diagnosed with metastatic prostate cancer. A 54-year-old man presented with dysarthria and progressive weakness, later revealing signs of hypoglossal nerve paralysis, unilateral tongue atrophy, and skeletal metastases involving the base of the skull. Imaging studies, including CT and MRI, confirmed diffuse lytic lesions and cranial nerve entrapment. Further investigations identified elevated PSA levels, confirming acinar prostate adenocarcinoma. The patient underwent hormone therapy due to the poor prognosis. Prostate cancer's skeletal metastases are well-documented, but cranial nerve involvement remains rare, particularly with isolated XII nerve manifestation. The discussion emphasizes the diagnostic challenges, imaging techniques' roles, and the impact on prognosis and quality of life. This case underscores the rarity of unilateral XII nerve involvement as the initial presentation of metastatic prostate cancer. Clinicians should consider this manifestation, especially in men over 40, warranting a thorough diagnostic approach, including PSA measurement and referral for appropriate oncological and urological interventions.
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Affiliation(s)
- Mohammed Zahran
- Neurology DepartmentManolo Morales Peralta HospitalManaguaNicaragua
| | - Henry Larios
- Pathology DepartmentManolo Morales Peralta HospitalManaguaNicaragua
| | - Victor Rosales
- Nuclear Medicine DepartmentNora Astorga HospitalManaguaNicaragua
| | - Adrian Coulson
- Neurology DepartmentManolo Morales Peralta HospitalManaguaNicaragua
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15
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Evbuomwan O, Endres W, Tebeila T, Engelbrecht G. Atypical Presentation of Metastatic Castrate-resistant Prostate Cancer in a Middle Aged African Male with Good Response to Radioligand Therapy. Mol Imaging Radionucl Ther 2024; 33:57-62. [PMID: 38390823 PMCID: PMC10899738 DOI: 10.4274/mirt.galenos.2023.13471] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2024] Open
Abstract
Prostate cancer typically follows a characteristic pattern of metastatic spread to the pelvic lymph nodes and bone. Atypical patterns of metastasis are rare but have been documented. In African men, this disease tends to follow a more aggressive course, with the possibility of an atypical site of metastatic spread. We present a case of a 58-year- old African male with metastatic castrate-resistant prostate cancer who presented with both typical and atypical patterns of metastatic disease detected by a fluorine 18 prostate-specific membrane antigen positron emission tomography/computed tomography scan. This patient also had a good response to radioligand therapy.
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Affiliation(s)
- Osayande Evbuomwan
- University of The Free State, Department of Nuclear Medicine, Bloemfontein, South Africa
| | - Walter Endres
- University of The Free State, Department of Nuclear Medicine, Bloemfontein, South Africa
| | - Tebatso Tebeila
- University of The Free State, Department of Nuclear Medicine, Bloemfontein, South Africa
| | - Gerrit Engelbrecht
- University of The Free State, Department of Nuclear Medicine, Bloemfontein, South Africa
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16
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Fernandes S, Oliver-De La Cruz J, Morazzo S, Niro F, Cassani M, Ďuríková H, Caravella A, Fiore P, Azzato G, De Marco G, Lauria A, Izzi V, Bosáková V, Fric J, Filipensky P, Forte G. TGF-β induces matrisome pathological alterations and EMT in patient-derived prostate cancer tumoroids. Matrix Biol 2024; 125:12-30. [PMID: 37944712 DOI: 10.1016/j.matbio.2023.11.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Revised: 09/28/2023] [Accepted: 11/06/2023] [Indexed: 11/12/2023]
Abstract
Extracellular matrix (ECM) tumorigenic alterations resulting in high matrix deposition and stiffening are hallmarks of adenocarcinomas and are collectively defined as desmoplasia. Here, we thoroughly analysed primary prostate cancer tissues obtained from numerous patients undergoing radical prostatectomy to highlight reproducible structural changes in the ECM leading to the loss of the glandular architecture. Starting from patient cells, we established prostate cancer tumoroids (PCTs) and demonstrated they require TGF-β signalling pathway activity to preserve phenotypical and structural similarities with the tissue of origin. By modulating TGF-β signalling pathway in PCTs, we unveiled its role in ECM accumulation and remodelling in prostate cancer. We also found that TGF-β-induced ECM remodelling is responsible for the initiation of prostate cell epithelial-to-mesenchymal transition (EMT) and the acquisition of a migratory, invasive phenotype. Our findings highlight the cooperative role of TGF-β signalling and ECM desmoplasia in prompting prostate cell EMT and promoting tumour progression and dissemination.
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Affiliation(s)
- Soraia Fernandes
- International Clinical Research Center, St. Anne's University Hospital, Brno 60200, Czech Republic.
| | - Jorge Oliver-De La Cruz
- International Clinical Research Center, St. Anne's University Hospital, Brno 60200, Czech Republic
| | - Sofia Morazzo
- International Clinical Research Center, St. Anne's University Hospital, Brno 60200, Czech Republic; Faculty of Medicine, Department of Biomedical Sciences, Masaryk University, Brno 62500, Czech Republic
| | - Francesco Niro
- International Clinical Research Center, St. Anne's University Hospital, Brno 60200, Czech Republic; Faculty of Medicine, Department of Biomedical Sciences, Masaryk University, Brno 62500, Czech Republic
| | - Marco Cassani
- International Clinical Research Center, St. Anne's University Hospital, Brno 60200, Czech Republic
| | - Helena Ďuríková
- International Clinical Research Center, St. Anne's University Hospital, Brno 60200, Czech Republic
| | - Alessio Caravella
- Department of Computer Engineering, Modelling, Electronics and Systems Engineering (DIMES), University of Calabria (UNICAL), Via P. Bucci, Cubo 42C, Rende (CS) 87036, Italy
| | - Piergiuseppe Fiore
- Department of Computer Engineering, Modelling, Electronics and Systems Engineering (DIMES), University of Calabria (UNICAL), Via P. Bucci, Cubo 42C, Rende (CS) 87036, Italy
| | - Giulia Azzato
- Department of Computer Engineering, Modelling, Electronics and Systems Engineering (DIMES), University of Calabria (UNICAL), Via P. Bucci, Cubo 42C, Rende (CS) 87036, Italy
| | - Giuseppe De Marco
- Information Technology Center (ICT), University of Calabria (UNICAL), Via P. Bucci, Cubo 22B, Rende (CS) 87036, Italy
| | - Agostino Lauria
- Department of Engineering for Innovation, University of Salento (UNISALENTO), Corpo Z, Campus Ecotekne, SP.6 per Monteroni, Lecce (LE), Italy
| | - Valerio Izzi
- Faculty of Biochemistry and Molecular Medicine, University of Oulu, Oulu FI-90014, Finland; Faculty of Medicine, BioIM Research Unit, University of Oulu, Oulu FI-90014, Finland; Foundation for the Finnish Cancer Institute, Tukholmankatu 8, Helsinki, Finland
| | - Veronika Bosáková
- International Clinical Research Center, St. Anne's University Hospital, Brno 60200, Czech Republic; Faculty of Medicine, Department of Biomedical Sciences, Masaryk University, Brno 62500, Czech Republic
| | - Jan Fric
- International Clinical Research Center, St. Anne's University Hospital, Brno 60200, Czech Republic; Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - Petr Filipensky
- Department of Urology, St. Anne's University Hospital, Brno 60200, Czech Republic
| | - Giancarlo Forte
- International Clinical Research Center, St. Anne's University Hospital, Brno 60200, Czech Republic; School of Cardiovascular and Metabolic Medicine & Sciences, King's College London, London SE5 9NU, UK.
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17
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Stanzel S, Weitzer F, Janek E, Plhak E, Aigner RM. Atypical Presentation of Liver Metastases of Prostate Cancer in 68Ga-PSMA-11 PET/CT. Clin Nucl Med 2023; 48:1064-1065. [PMID: 37934704 DOI: 10.1097/rlu.0000000000004898] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2023]
Abstract
ABSTRACT 68Ga-PSMA-11 (68Ga-prostate-specific membrane antigen-11) PET/CT continues to have a great clinical value for staging in prostate cancer. Lymph nodes and bone are the most typical metastatic sites of prostate cancer, whereas liver metastases are rare and usually show focally increased tracer uptake in 68Ga-PSMA-11 PET/CT. Here, we present an 88-year-old man with histologically proven metastatic castration-resistant prostate cancer and extensive PSMA-negative liver metastases identified by 68Ga-PSMA-11 PET/CT. This finding is remarkable because the decreased liver uptake of 68Ga-PSMA-11 may resemble a primary hepatic tumor.
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Affiliation(s)
| | | | - Elmar Janek
- Division of General Radiology, Department of Radiology, Medical University of Graz, Graz, Austria
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18
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Sumitomo K, Ashida S, Hiroi M, Shinohara T. Prostatic lymphangitis carcinomatosis with massive bilateral pleural effusion. Am J Med Sci 2023; 366:e62-e63. [PMID: 37277095 DOI: 10.1016/j.amjms.2023.05.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2022] [Revised: 05/23/2023] [Accepted: 05/30/2023] [Indexed: 06/07/2023]
Affiliation(s)
- Kenya Sumitomo
- Division of Internal Medicine, Japan Agricultural Cooperatives Kochi Hospital, 526-1 Myoken-aza-Nakano, Nankoku, Kochi 783-8509, Japan
| | - Shingo Ashida
- Department of Urology, Kochi Medical School, Kochi University, 185-1, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
| | - Makoto Hiroi
- Department of Diagnostic Pathology, Kochi University Hospital, 185-1, Oko-cho, Kohasu, Nankoku, Kochi, 783-8505, Japan
| | - Tsutomu Shinohara
- Division of Internal Medicine, Japan Agricultural Cooperatives Kochi Hospital, 526-1 Myoken-aza-Nakano, Nankoku, Kochi 783-8509, Japan; Department of Community Medicine for Respirology, Graduate School of Biomedical Sciences, Tokushima University, 3-18-15 Kuramoto-cho, Tokushima 770-8503, Japan.
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19
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Segal E, Dababo N, Bhalla D, Bucklan D. Prostate Adenocarcinoma Metastasis to the Rectal Submucosa and Mesorectal Lymph Node on 18 F-PSMA PET/CT. Clin Nucl Med 2023; 48:e506-e508. [PMID: 37656605 DOI: 10.1097/rlu.0000000000004795] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/03/2023]
Abstract
ABSTRACT We report a case of biopsy-proven prostate cancer metastasis to the rectum and presumed metastasis to a mesorectal lymph node, identified as radiotracer-avid lesions on prostate-specific membrane antigen PET/CT during workup for biochemically recurrent prostate cancer. This case adds to a growing number of atypical sites of metastatic prostate cancer being reported since the approval of prostate-specific membrane antigen PET/CT for staging of prostate cancer.
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Affiliation(s)
- Eric Segal
- From the Department of Radiology, Froedtert & the Medical College of Wisconsin, Milwaukee, WI
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20
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Ba'th F, Hutchinson T, Meares A, Hamlar D. Metastatic Prostate Cancer Involving the Sphenoid Sinus and Mandible. EAR, NOSE & THROAT JOURNAL 2023; 102:NP470-NP473. [PMID: 34039052 DOI: 10.1177/01455613211006009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Prostate cancer is the third most leading cause of cancer in men in the United States. Although expected metastatic spread to bone, liver, and lymph nodes are often monitored, there are other rare presentations that can occur. This case report demonstrates a rare presentation of prostate cancer spreading to the paranasal sinuses and orbit. Not only did this case have an atypical presentation mimicking infection, the diagnosis was also only achieved through pathological evaluation after an endoscopic examination and biopsy. This case demonstrates the importance of a low threshold for endoscopic examinations in uncertain sinonasal presentations, and consistent biopsies when performing endoscopic examinations.
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Affiliation(s)
- Fadlullah Ba'th
- University of Minnesota Medical School, Minneapolis, MN, USA
| | - Tanisha Hutchinson
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
| | - Annie Meares
- HealthPartners Regions Hospital, Saint Paul, MN, USA
| | - David Hamlar
- Department of Otolaryngology-Head and Neck Surgery, University of Minnesota, Minneapolis, MN, USA
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21
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Zhang H, Du Y, Xin P, Man X. The LINC00852/miR-29a-3p/JARID2 axis regulates the proliferation and invasion of prostate cancer cell. BMC Cancer 2022; 22:1269. [PMID: 36471281 PMCID: PMC9724404 DOI: 10.1186/s12885-022-10263-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2022] [Accepted: 11/01/2022] [Indexed: 12/12/2022] Open
Abstract
Long intergenic non-coding RNA 00852 (LINC00852) has been shown to promote the progression of many different cancers including prostate cancer. However, the involved mechanism in promoting the proliferation, migration and invasion of prostate cancer cells has not been reported. In this study, we found that LINC00852 was highly expressed in the tissue of prostate cancer using quantitative reverse transcription PCR (qRT-PCR). CCK-8 assay, colony formation experiment, Transwell migration and invasion experiments were performed to prove that the up-regulation of LINC00852 could promote the proliferation, migration and invasion of prostate cancer cells in vitro. Xenograft tumors experiments in nude mice confirmed that up-regulation of LINC00852 promoted the proliferation of prostate cancer cells in vivo. Bioinformatics predictions and dual-luciferase reporter gene assay showed that miR-29a-3p binds to the 3'-untranslated region of JARID2, and the enhancement of miR-29a-3p could reverse the effect of LINC00852 overexpression in vitro. Moreover, the results of qRT-PCR and western blot showed that LINC00852 could regulate the expression of JARID2 through miR-29a-3p induction. In summary, we demonstrated that LINC00852 played a key role in promoting the prostate cancer, and LINC00852/miR-29a-3p/JARID2 axis could be used as a target for prostate cancer treatment.
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Affiliation(s)
- Hao Zhang
- grid.412636.40000 0004 1757 9485Department of Urology, The First Hospital of China Medical University, 155 North Nanjing Street, 110001 Shenyang, Liaoning China ,grid.412449.e0000 0000 9678 1884Institute of Urology, China Medical University, Liaoning Shenyang, China
| | - Yang Du
- grid.412636.40000 0004 1757 9485Department of Urology, The First Hospital of China Medical University, 155 North Nanjing Street, 110001 Shenyang, Liaoning China
| | - Peng Xin
- grid.412636.40000 0004 1757 9485Department of Urology, The First Hospital of China Medical University, 155 North Nanjing Street, 110001 Shenyang, Liaoning China
| | - Xiaojun Man
- grid.412636.40000 0004 1757 9485Department of Urology, The First Hospital of China Medical University, 155 North Nanjing Street, 110001 Shenyang, Liaoning China
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22
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Okudan B, Seven B, Ural B, Çapraz M. Detection of COVID-19 Incidentally in 68Ga-PSMA PET/CT for Restaging of Prostate Cancer. Curr Med Imaging 2022; 18:1532-1535. [PMID: 35490331 DOI: 10.2174/1573405618666220427134647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/01/2022] [Revised: 02/01/2022] [Accepted: 02/09/2022] [Indexed: 01/25/2023]
Abstract
BACKGROUND A series of pneumonia cases with clinical presentations of viral pneumonia secondary to new coronavirus and subsequent global transmission arose in Wuhan, Hubei, China, in December 2019. Several cases of coronavirus disease 2019 (COVID-19) have been described incidentally in positron emission tomography-computed tomography (PET/CT) with 18F-fluorodeoxyglucose (FDG) as a result of the pandemic. Herein, we describe the findings of a patient with unknown COVID-19 in PET/CT with the other radiopharmaceutical, 68Ga-labeled prostatespecific membrane antigen (68Ga-PSMA). CASE REPORT A 69-year-old man had previously undergone radical prostatectomy for adenocarcinoma. 68Ga-PSMA PET/CT imaging was performed due to biochemical recurrence. 68Ga-PSMA uptake in the prostate bed suggestive of local recurrence was detected in PET/CT images. Also, bilateral groundglass opacities with slightly increased 68Ga-PSMA uptake were seen in the lungs, suspected of COVID-19. A reverse transcription-polymerase chain reaction test has confirmed the infection. CONCLUSION Even in asymptomatic patients, nuclear medicine departments must be aware of the possibility of COVID-19, take appropriate post-exposure procedures, and protect employees and other patients.
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Affiliation(s)
- Berna Okudan
- Department of Nuclear Medicine, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Bedri Seven
- Department of Nuclear Medicine, Sabuncuoğlu Şerefeddin Training and Research Hospital, University of Amasya, Amasya, Turkey
| | - Betül Ural
- Department of Nuclear Medicine, Ankara City Hospital, University of Health Sciences, Ankara, Turkey
| | - Mustafa Çapraz
- Department of Internal Medicine, School of Medicine, University of Amasya, Amasya, Turkey
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23
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PSMA PET for the Evaluation of Liver Metastases in Castration-Resistant Prostate Cancer Patients: A Multicenter Retrospective Study. Cancers (Basel) 2022; 14:cancers14225680. [PMID: 36428771 PMCID: PMC9688898 DOI: 10.3390/cancers14225680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2022] [Revised: 11/09/2022] [Accepted: 11/16/2022] [Indexed: 11/22/2022] Open
Abstract
Background: To evaluate the diagnostic performance of PSMA-PET compared to conventional imaging/liver biopsy in the detection of liver metastases in CRPC patients. Moreover, we evaluated a PSMA-PET/CT-based radiomic model able to identify liver metastases. Methods: Multicenter retrospective study enrolling patients with the following inclusion criteria: (a) proven CRPC patients, (b) PSMA-PET and conventional imaging/liver biopsy performed in a 6 months timeframe, (c) no therapy changes between PSMA-PET and conventional imaging/liver biopsy. PSMA-PET sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy for liver metastases were calculated. After the extraction of radiomic features, a prediction model for liver metastases identification was developed. Results: Sixty CRPC patients were enrolled. Within 6 months before or after PSMA-PET, conventional imaging and liver biopsy identified 24/60 (40%) patients with liver metastases. PSMA-PET sensitivity, specificity, PPV, NPV, and accuracy for liver metastases were 0.58, 0.92, 0.82, 0.77, and 0.78, respectively. Either number of liver metastases and the maximum lesion diameter were significantly associated with the presence of a positive PSMA-PET (p < 0.05). On multivariate regression analysis, the radiomic feature-based model combining sphericity, and the moment of inverse difference (Idm), had an AUC of 0.807 (95% CI:0.686-0.920). Conclusion: For liver metastases assessment, [68Ga]Ga-PSMA-11-PET demonstrated moderate sensitivity while high specificity, PPV, and inter-reader agreement compared to conventional imaging/liver biopsy in CRPC patients.
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24
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Bazo accesorio intratorácico que imita la metástasis pleural en PET/TC con 68Ga-PSMA, confirmada con gammagrafía selectiva de bazo. Rev Esp Med Nucl Imagen Mol 2022. [DOI: 10.1016/j.remn.2021.09.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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25
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Sharma H, Franklin M, Braunberger R, Hashemi-Sadraei N. Cutaneous metastasis from prostate cancer: A case report with literature review. CURRENT PROBLEMS IN CANCER: CASE REPORTS 2022. [DOI: 10.1016/j.cpccr.2022.100175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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26
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Chen Z, Qu M, Shen X, Jiang S, Zhang W, Ji J, Wang Y, Zhang J, Chen Z, Lin L, Li M, Wu C, Gao X. Establishment of an Individualized Predictive Model to Reduce the Core Number for Systematic Prostate Biopsy: A Dual Center Study Based on Stratification of the Disease Risk Score. Front Oncol 2022; 11:831603. [PMID: 35237503 PMCID: PMC8882832 DOI: 10.3389/fonc.2021.831603] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2021] [Accepted: 12/27/2021] [Indexed: 11/17/2022] Open
Abstract
Purpose To establish an individualized prostate biopsy model that reduces unnecessary biopsy cores based on multiparameter MRI (mpMRI). Materials and Methods This retrospective, non-inferiority dual-center study retrospectively included 609 patients from the Changhai Hospital from June 2017 to November 2020 and 431 patients from the Fujian Union Hospital between 2014 and 2019. Clinical, radiological, and pathological data were analyzed. Data from the Changhai Hospital were used for modeling by calculating the patients’ disease risk scores. Data from the Fujian Union Hospital were used for external verification. Results Based on the data of 609 patients from the Changhai Hospital, we divided the patients evenly into five layers according to the disease risk score. The area under the receiver operating characteristic (ROC) curve (AUC) with 95% confidence intervals (CI) was analyzed. Twelve-core systemic biopsy (12-SBx) was used as the reference standard. The SBx cores from each layer were reduced to 9, 6, 5, 4, and 4. The data of 279 patients with benign pathological results from the Fujian Union Hospital were incorporated into the model. No patients were in the first layer. The accuracies of the models for the other layers were 88, 96.43, 94.87, and 94.59%. The accuracy of each layer would be increased to 96, 100, 100, and 97.30% if the diagnosis of non-clinically significant prostate cancer was excluded. Conclusions In this study, we established an individualized biopsy model using data from a dual center. The results showed great accuracy of the model, indicating its future clinical application.
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Affiliation(s)
- Zeyu Chen
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Min Qu
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Xianqi Shen
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Shaoqin Jiang
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
- Department of Urology, Fujian Union Hospital, Fujian Medical University, Fuzhou, China
| | - Wenhui Zhang
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Jin Ji
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Yan Wang
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Jili Zhang
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Zhenlin Chen
- Department of Urology, Fujian Union Hospital, Fujian Medical University, Fuzhou, China
| | - Lu Lin
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
| | - Mengqiang Li
- Department of Urology, Fujian Union Hospital, Fujian Medical University, Fuzhou, China
| | - Cheng Wu
- Department of Health Statistics, Second Military Medical University, Shanghai, China
| | - Xu Gao
- Department of Urology, Shanghai Changhai Hospital, Second Military Medical University, Shanghai, China
- *Correspondence: Xu Gao,
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Intrathoracic accessory spleen mimicking pleural metastasis in 68Ga-PSMA PET/CT, confirmed with selective spleen scintigraphy. Rev Esp Med Nucl Imagen Mol 2022; 41:380-382. [DOI: 10.1016/j.remnie.2021.10.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Maurer A, Schiesser H, Skawran S, Gennari AG, Dittli M, Burger IA, Mader C, Berger C, Eberli D, Huellner MW, Messerli M. Frequency and intensity of [18F]-PSMA-1007 uptake after COVID-19 vaccination in clinical PET. BJR Open 2022; 4:20210084. [PMID: 36017171 PMCID: PMC9364367 DOI: 10.1259/bjro.20210084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Accepted: 01/06/2022] [Indexed: 11/05/2022] Open
Abstract
Objectives: To assess the frequency and intensity of [18F]-PSMA-1007 axillary uptake in lymph nodes ipsilateral to COVID-19 vaccination with BNT162b2 (Pfizer-BioNTech) or mRNA-1273 (Moderna) in patients with prostate cancer referred for oncological [18F]-PSMA PET/CT or PET/MR imaging. Methods: One hundred twenty six patients undergoing [18F]-PSMA PET/CT or PET/MR imaging were retrospectively included. [18F]-PSMA activity (SUVmax) of ipsilateral axillary lymph nodes was measured and compared with the non-vaccinated contralateral side-and with a non-vaccinated negative control group. [18F]-PSMA active lymph node metastases were measured to serve as quantitative reference. Results: There was a significant difference in SUVmax in ipsilateral and compared to contralateral axillary lymph nodes in the vaccination group (n = 63, p < 0.001) and no such difference in the non-vaccinated control group (n = 63, p = 0.379). Vaccinated patients showed mildly increased axillary lymph node [18F]-PSMA uptake as compared to non-vaccinated patients (p = 0.03). [18F]-PSMA activity of of lymph node metastases was significantly higher (p < 0.001) compared to axillary lymph nodes of vaccinated patients. Conclusions: Our data suggest mildly increased [18F]-PSMA uptake after COVID-19 vaccination in ipsilateral axillary lymph nodes. However, given the significantly higher [18F]-PSMA uptake of prostatic lymph node metastases compared to “reactive” nodes after COVID-19 vaccination, no therapeutic and diagnostic dilemma is to be expected. Advances in knowledge: No specific preparations or precautions (e.g., adaption of vaccination scheduling) need to be undertaken in patients undergoing [18F]-PSMA PET imaging after COVID-19 vaccination.
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Affiliation(s)
- Alexander Maurer
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Helen Schiesser
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Stephan Skawran
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Antonio G. Gennari
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Manuel Dittli
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Irene A. Burger
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
- Department of Nuclear Medicine, Kantonsspital Baden, Baden, Switzerland
| | - Cäcilia Mader
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Christoph Berger
- University of Zurich, Zurich, Switzerland
- Division of Infectious Diseases and Children’s Research Centre, University Children’s Hospital Zurich, Zurich, Switzerland
| | - Daniel Eberli
- University of Zurich, Zurich, Switzerland
- Department of Urology, University Hospital Zurich, Zurich, Switzerland
| | - Martin W. Huellner
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
| | - Michael Messerli
- Department of Nuclear Medicine, University Hospital Zurich, Zurich, Switzerland
- University of Zurich, Zurich, Switzerland
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Ribeiro AMB, Lima ENP, Garcia D, Bezerra SM. Single Adrenal Metastasis From Prostate Cancer Detected by 68Ga-PSMA PET/CT and Confirmed by Biopsy: A Case Report. Clin Nucl Med 2022; 47:e61-e62. [PMID: 34319961 DOI: 10.1097/rlu.0000000000003829] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT This image demonstrates an unusual presentation of an adrenal metastasis from prostate cancer detected by 68Ga-prostate-specific membrane antigen PET/CT and confirmed by biopsy. A 68-year-old man with prostate cancer persisted with elevated levels of prostate-specific antigen after radical prostatectomy. Imaging identified a single abnormal uptake in the left adrenal gland. A biopsy was performed showing a metastatic prostatic adenocarcinoma. The patient received systemic treatment, and his prostate-specific antigen level decreased significantly. Our objective is to illustrate an unusual and single site of prostate cancer metastasis, in which precise histological diagnosis was essential for correct clinical management of the patient.
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Zhao Q, Yang B, Dong A, Zuo C. 68Ga-PSMA-11 PET/CT in Isolated Bilateral Adrenal Metastases From Prostate Adenocarcinoma. Clin Nucl Med 2022; 47:e101-e102. [PMID: 34115707 DOI: 10.1097/rlu.0000000000003759] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT A 65-year-old man with treated prostate adenocarcinoma underwent 68Ga-PSMA-11 PET/CT scan for restaging due to significantly increased serum PSA levels. PET/CT showed bilateral adrenal masses with high 68Ga-PSMA-11 uptake. There was no other lesion suspicious for metastasis. The laboratory and imaging findings were consisted with isolated bilateral adrenal metastases from prostate adenocarcinoma. The patient received docetaxel chemotherapy in combination with androgen deprivation therapy. PSA levels gradually decreased during chemotherapy. Follow-up MRI showed the bilateral adrenal masses significantly decreased in size. This case demonstrates the usefulness of 68Ga-PSMA-11 PET/CT in identifying atypical metastasis from prostate adenocarcinoma.
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Affiliation(s)
- Qian Zhao
- From the Department of Nuclear Medicine, General Hospital of Ningxia Medical University, Yinchuan, Ningxia
| | | | - Aisheng Dong
- Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai, China
| | - Changjing Zuo
- Nuclear Medicine, Changhai Hospital, Navy Medical University, Shanghai, China
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31
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Waltz J, Mercer MK, Dani G, Rieter WJ. Incidental Serous Cystadenoma Presenting as a Photopenic Pancreatic Defect on 18F-Fluciclovine PET/CT. Clin Nucl Med 2021; 46:e600-e602. [PMID: 34735415 DOI: 10.1097/rlu.0000000000003670] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
ABSTRACT 18F-fluciclovine (Axumin) PET/CT has been widely used for the evaluation of biochemically recurrent prostate cancer following prior treatment. While lymph node and visceral organ metastases typically show increased radiotracer uptake, altered patterns of normal physiologic activity may also provide insight into other disease processes. We present a case of an incidental pancreatic head mass presenting as a photopenic defect on a staging 18F-fluciclovine PET/CT, which was subsequently confirmed to be a benign serous cystadenoma using multisequence MRI.
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Affiliation(s)
- Jeffrey Waltz
- From the Department of Radiology, Medical University of South Carolina
| | - Megan K Mercer
- From the Department of Radiology, Medical University of South Carolina
| | - Genta Dani
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, SC
| | - William J Rieter
- From the Department of Radiology, Medical University of South Carolina
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Tilmans G, Navez J, Komuta M, Saussez T, Lerut J. Solitary prostate cancer liver metastasis: an exceptional indication for liver resection. Acta Chir Belg 2021; 121:427-431. [PMID: 32000583 DOI: 10.1080/00015458.2020.1722929] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
INTRODUCTION Prostatic cancer metastases (PCM) are usually systemic. Isolated PCM liver metastases (PCLM) are very rare. The treatment of PCM consists of hormono- and chemotherapy eventually combined with stereotactic radiation. PATIENT AND DISCUSSION A case of a 67-year old man presenting with a solitary, metachronous PCLM undergoing a left extended hepatectomy due to resistance to hormono- and chemotherapy is reported. He died of recurrent systemic disease 31 months later. CONCLUSIONS The very rare indication and possible role of liver resection in the treatment of PCLM is discussed.
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Affiliation(s)
- Gilles Tilmans
- Starzl Unit of Abdominal Transplantation, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Julie Navez
- Starzl Unit of Abdominal Transplantation, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Mina Komuta
- Department of Pathology, Cliniques Universitaires Saint Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Thibaud Saussez
- Department of Urology, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
| | - Jan Lerut
- Starzl Unit of Abdominal Transplantation, Cliniques Universitaires Saint-Luc, Université Catholique de Louvain, Brussels, Belgium
- IREC - Centre for Experimental and Clincal Research, Université catholique Louvain, Brussels, Belgium
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Abstract
More than 40% of men with intermediate-risk or high-risk prostate cancer will experience a biochemical recurrence after radical prostatectomy. Clinical guidelines for the management of these patients largely focus on the use of salvage radiotherapy with or without systemic therapy. However, not all patients with biochemical recurrence will go on to develop metastases or die from their disease. The optimal pre-salvage therapy investigational workup for patients who experience biochemical recurrence should, therefore, include novel techniques such as PET imaging and genomic analysis of radical prostatectomy specimen tissue, as well as consideration of more traditional clinical variables such as PSA value, PSA kinetics, Gleason score and pathological stage of disease. In patients without metastatic disease, the only known curative intervention is salvage radiotherapy but, given the therapeutic burden of this treatment, importance must be placed on accurate timing of treatment, radiation dose, fractionation and field size. Systemic therapy also has a role in the salvage setting, both concurrently with radiotherapy and as salvage monotherapy.
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Curcean A, Curcean S, Rescigno P, Dafydd DA, Tree A, Reid A, Koh DM, Sohaib A, Tunariu N, Shur J. Imaging features of the evolving patterns of metastatic prostate cancer. Clin Radiol 2021; 77:88-95. [PMID: 34598790 DOI: 10.1016/j.crad.2021.09.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 09/02/2021] [Indexed: 12/28/2022]
Abstract
The pattern of metastases in prostate cancer (PC) is evolving. Increased use of imaging, newer imaging techniques with higher sensitivity for disease detection and patients receiving multiple lines of novel therapies with increased life expectancy are likely to be contributory. Awareness of metastatic disease patterns improves early diagnosis, accurate staging, and initiation of appropriate therapy, and can inform prognostic information and anticipate potential disease complications. The aim of this review is to document the spectrum of metastases in PC including emerging and unusual patterns, and to highlight the role of novel imaging including prostate-specific membrane antigen (PSMA)-positron-emission tomography (PET) and whole-body magnetic resonance imaging (WB-MRI) to improve diagnostic and response assessment accuracy.
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Affiliation(s)
- A Curcean
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, Sutton, Surrey, UK
| | - S Curcean
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - P Rescigno
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - D Ap Dafydd
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - A Tree
- Institute of Cancer Research, Sutton, Surrey, UK; Academic Uro-oncology Unit, The Royal Marsden NHS Foundation Trust, UK
| | - A Reid
- Institute of Cancer Research, Sutton, Surrey, UK; Academic Uro-oncology Unit, The Royal Marsden NHS Foundation Trust, UK
| | - D-M Koh
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, Sutton, Surrey, UK
| | - A Sohaib
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK
| | - N Tunariu
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK; Institute of Cancer Research, Sutton, Surrey, UK
| | - J Shur
- Department of Radiology, The Royal Marsden NHS Foundation Trust, UK.
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Prospective comparison of simultaneous [ 68Ga]Ga-PSMA-11 PET/MR versus PET/CT in patients with biochemically recurrent prostate cancer. Eur Radiol 2021; 32:901-911. [PMID: 34374802 DOI: 10.1007/s00330-021-08140-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2021] [Revised: 05/25/2021] [Accepted: 06/12/2021] [Indexed: 10/20/2022]
Abstract
OBJECTIVES PSMA-PET has become the PET technique of choice to localise the site of biochemically recurrent prostate cancer (PCa). With hybrid PET/MRI, the advantages of MRI are added to molecular characteristic of PET. The aim of this study was to investigate the incremental value of PET/MR versus PET/CT in patients with biochemically recurrent PCa by head-to-head comparison. METHODS Thirty-four patients with biochemically recurrent PCa were prospectively included. They underwent [68Ga]Ga-PSMA-11 PET/CT, followed by simultaneous PET/MR. All PET (PETCT, PETMR), CT and MR images were evaluated for number of lesions and location. The number of lesions at specific sites was compared using Wilcoxon-sign-rank test. For PET, the maximum and mean standardised uptake values (SUVs) were calculated for each lesion compared using a two-sided paired t test. RESULTS PETCT and PETMR scans were positive in 19 and 20 patients, detecting 73 and 79 lesions respectively. All lesions detected on PETCT were also detected on PETMR. CT and MRI only were positive in 14 and 17 patients, detecting 38 and 50 lesions, respectively, which was significantly lower than PETCT and PETMR respectively. Combined interpretation showed more lesions on PET/MR than on PET/CT (88 vs 81). No significant difference in detection of presence of local recurrence nor distant metastases was found. SUVmean and SUVmax values were significantly higher on PETMR than on PETCT in local recurrence and lymph node metastases. CONCLUSIONS [68Ga]Ga-PSMA-11 PET/MR was able to detect biochemically recurrent PCa at least as accurately as PET/CT for local recurrence, lymph node metastasis and distant metastasis. KEY POINTS • PSMA PET/MRI detects the location of biochemical recurrence at least as accurately as PET/CT. • Substitution of PET/CT by PET/MRI adds sensitivity in PSMA lesion detection also in the setting of distant recurrence due to both the MR and TOF PET components.
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Atypical Metastases in the Abdomen and Pelvis From Biochemically Recurrent Prostate Cancer: 11C-Choline PET/CT Imaging With Multimodality Correlation. AJR Am J Roentgenol 2021; 218:141-150. [PMID: 34346785 DOI: 10.2214/ajr.21.26426] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
PET imaging with targeted radiotracers has become integral for mapping the location and burden of recurrent disease in patients with biochemical recurrence (BCR) of prostate cancer (PCa). PET with 11C-choline is part of the National Comprehensive Cancer Network and European Association of Urology guidelines for evaluation of BCR. With advances in PET technology, increasing use of targeted radiotracers, and improved survival of patients with BCR due to novel therapeutics, atypical sites of metastases are being increasingly encountered, challenging the conventional view that PCa rarely metastasizes beyond bones or lymph nodes. We describe such atypical metastases in the abdomen and pelvis on 11C-choline PET (including in the liver, pancreas, genital tract, urinary tract, peritoneum, and abdominal wall, as well as perineural spread), presenting multimodality imaging features and relevant imaging pitfalls. Given atypical metastases' inconsistent relationship with serum PSA and non-specific presenting symptoms, they are often first detected on imaging. Awareness of their imaging features is important as their detection impacts clinical management, patient counseling, prognosis, and clinical trial eligibility. Such awareness is particularly critical as the role of radiologists in the imaging and management of BCR will continue to increase given the expanding regulatory approvals of other targeted and theranostic radiotracers.
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Singh DK, Patel VG, Oh WK, Aguirre-Ghiso JA. Prostate Cancer Dormancy and Reactivation in Bone Marrow. J Clin Med 2021; 10:2648. [PMID: 34208521 PMCID: PMC8234151 DOI: 10.3390/jcm10122648] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 06/03/2021] [Accepted: 06/14/2021] [Indexed: 12/14/2022] Open
Abstract
Prostate cancer has a variable clinical course, ranging from curable local disease to lethal metastatic spread. Eradicating metastatic cells is a unique challenge that is rarely met with the available therapies. Thus, targeting prostate cancer cells in earlier disease states is a crucial window of opportunity. Interestingly, cancer cells migrate from their primary site during pre-cancerous and malignant phases to seed secondary organs. These cells, known as disseminated cancer cells (DCCs), may remain dormant for months or decades before activating to form metastases. Bone marrow, a dormancy-permissive site, is the major organ for housed DCCs and eventual metastases in prostate cancer. The dynamic interplay between DCCs and the primary tumor microenvironment (TME), as well as that between DCCs and the secondary organ niche, controls the conversion between states of dormancy and activation. Here, we discuss recent discoveries that have improved our understanding of dormancy signaling and the role of the TME in modulating the epigenetic reprogramming of DCCs. We offer potential strategies to target DCCs in prostate cancer.
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Affiliation(s)
- Deepak K. Singh
- Division of Hematology and Oncology, Department of Medicine, Department of Otolaryngology, Department of Oncological Sciences, Tisch Cancer Institute, Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Vaibhav G. Patel
- Division of Hematology and Oncology, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - William K. Oh
- Division of Hematology and Oncology, Department of Medicine, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
| | - Julio A. Aguirre-Ghiso
- Division of Hematology and Oncology, Department of Medicine, Department of Otolaryngology, Department of Oncological Sciences, Tisch Cancer Institute, Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA;
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Yamaga LYI, da Cunha ML. Atypical metastases from prostate cancer detected on 68Ga-PSMA PET/CT: a case series. Int Braz J Urol 2021; 47:205-209. [PMID: 33047931 PMCID: PMC7712681 DOI: 10.1590/s1677-5538.ibju.2020.0069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/02/2020] [Accepted: 04/29/2020] [Indexed: 02/05/2023] Open
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Mremi A, Mbwambo OJ, Bright F, Mbwambo JS, Mteta KA, Ngowi BN. Left axillary lymphadenopathy as initial presentation of metastatic prostate cancer: A rare case report. Int J Surg Case Rep 2021; 82:105889. [PMID: 33878669 PMCID: PMC8081923 DOI: 10.1016/j.ijscr.2021.105889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 04/10/2021] [Accepted: 04/12/2021] [Indexed: 12/24/2022] Open
Abstract
Theoretically, prostate cancer can spread to any part of the body. Metastasis to axillary lymph node in a patient with normal urologic examination is rare. It may delay the diagnosis. A high suspicion index is essential in males presenting with symptoms suggestive of chest and abdominal-pelvic cancer. Introduction and importance Advanced prostate cancer often presents with lower urinary tract symptoms together with features of cancer on digital rectal examination. The commonest sites of metastasis include bone, liver and lungs. Metastasis to axillary lymph nodes is extremely unusual particularly as initial presentation of the disease. Case presentation We report an atypical case of a 40-year male patient presented with left axillary mass and normal initial urological evaluation. Histopathology and immunohistochemistry of the biopsies from the axillary mass and prostate confirmed the diagnosis of prostate adenocarcinoma. The patient declined anti-androgen monotherapy treatment and succumbed two months after establishment of the diagnosis. Clinical discussion Prostate cancer contributes significantly to the overall global cancer burden. Lymphatic metastasis to axillary lymph nodes is a very rare manifestation of prostate cancer and only a few cases have been reported in the literature. Therefore, clinical diagnosis of patients presenting with axillary lymphadenopathy may cause diagnostic delay. Careful physical and imaging examinations combined with pathological analysis are essential in the diagnosis of advanced prostate cancer with unusual presentation. Conclusion In theory, prostate cancer can cause metastatic spread to any part of the body. However, metastasis to axillary nodes has not been frequently noticed. Our report highlights the importance of considering prostate cancer among differential diagnoses in Afro-Caribbean males presenting with symptoms suggestive of chest and abdomino-pelvic cancer.
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Affiliation(s)
- Alex Mremi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania; Department of Pathology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania.
| | - Orgeness J Mbwambo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania
| | - Frank Bright
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania
| | - Jasper S Mbwambo
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania
| | - Kien A Mteta
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania
| | - Bartholomeo N Ngowi
- Faculty of Medicine, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania
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Bhattacharjee A, Roy G, Budukh A, Dikshit R, Patil VM, Joshi A, Noronha V, Prabash K, Roy P. A competing risk analysis of death patterns in male genitourinary cancer. Cancer Rep (Hoboken) 2020; 3:e1174. [DOI: 10.1002/cnr2.1174] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2018] [Revised: 12/26/2018] [Accepted: 12/26/2018] [Indexed: 11/11/2022] Open
Affiliation(s)
- Atanu Bhattacharjee
- Section of Biostatistics, Centre for Cancer EpidemiologyTata Memorial Centre Navi Mumbai India
| | - Gaurav Roy
- Molecular Genetics Laboratory, Institute of Medical Genetics and GenomicsSir Ganga Ram Hospital New Delhi India
| | - Atul Budukh
- Centre for Cancer EpidemiologyTata Memorial Centre Navi Mumbai India
| | - Rajesh Dikshit
- Centre for Cancer EpidemiologyTata Memorial Centre Navi Mumbai India
| | - Vijay M. Patil
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Amit Joshi
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Vanita Noronha
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Kumar Prabash
- Department of Medical Oncology, Tata Memorial HospitalTata Memorial Centre Mumbai India
| | - Papai Roy
- Biochemical Genetics LaboratoryInstitute of Medical Genetics and Genomics, Sir Ganga Ram Hospital New Delhi India
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Cytokines and Chemokines as Mediators of Prostate Cancer Metastasis. Int J Mol Sci 2020; 21:ijms21124449. [PMID: 32585812 PMCID: PMC7352203 DOI: 10.3390/ijms21124449] [Citation(s) in RCA: 110] [Impact Index Per Article: 22.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2020] [Revised: 06/19/2020] [Accepted: 06/21/2020] [Indexed: 12/16/2022] Open
Abstract
The consequences of prostate cancer metastasis remain severe, with huge impact on the mortality and overall quality of life of affected patients. Despite the convoluted interplay and cross talk between various cell types and secreted factors in the metastatic process, cytokine and chemokines, along with their receptors and signaling axis, constitute important factors that help drive the sequence of events that lead to metastasis of prostate cancer. These proteins are involved in extracellular matrix remodeling, epithelial-mesenchymal-transition, angiogenesis, tumor invasion, premetastatic niche creation, extravasation, re-establishment of tumor cells in secondary organs as well as the remodeling of the metastatic tumor microenvironment. This review presents an overview of the main cytokines/chemokines, including IL-6, CXCL12, TGFβ, CXCL8, VEGF, RANKL, CCL2, CX3CL1, IL-1, IL-7, CXCL1, and CXCL16, that exert modulatory roles in prostate cancer metastasis. We also provide extensive description of their aberrant expression patterns in both advanced disease states and metastatic sites, as well as their functional involvement in the various stages of the prostate cancer metastatic process.
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42
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Impact of PSMA PET/CT in prostate cancer patient’s clinical management: a pictorial essay of interesting cases with histologic confirmation. Clin Transl Imaging 2020. [DOI: 10.1007/s40336-020-00372-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Sharma A, Sinha RJ, Garg G, Agarwal S, Akhtar A, Singh V. Special emphasis on bone health management in prostate cancer patients: a prospective longitudinal study. Int Braz J Urol 2020; 46:363-373. [PMID: 32167698 PMCID: PMC7088500 DOI: 10.1590/s1677-5538.ibju.2019.0023] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2019] [Accepted: 09/15/2019] [Indexed: 11/22/2022] Open
Abstract
Introduction: Use of androgen deprivation therapy (ADT) in carcinoma prostate (CaP) has deleterious effect on bone mineral density (BMD) leading to increase incidence of osteoporosis and skeletal-related events. We evaluated bone health status and impact of bone-directed therapy (BDT) and ADT on BMD in these patients from Jan 2015-Dec 2018. Materials and Method: Baseline bone health was assessed using Tc-99 MDP Bone scan/ DEXA scan for patients on ADT. Monthly zoledronic acid (ZA) was given to high-risk candidates (T-score ≤2.5 or previous hip/vertebral fracture) or Skel et al. metastatic patients who were receiving ADT. Baseline and follow-up (at 12-months) BMD using DEXA scan at various sites (spine, femur total, femur neck and radius) and subjective improvement in bony pain using Numeric Pain Rating Score after administration of ZA were compared. Results: A total of 96-patients of locally advanced and metastatic prostate cancer receiving ADT with or without BDT were included in the study cohort. Mean age of presentation was 68.4±15.61 years. Median serum PSA was 32.2±13.1ng/mL. There was significant improvement in mean BMD (T-score) in 64-patients post ZA therapy at 12-months (at femoral total, femoral neck and spine; 0.95, 0.79 and 0.68, respectively) (p <0.05) while there was significant deterioration in mean BMD at 12-months (at spine, femoral neck and femoral total; −0.77, −0.55 and −0.66, respectively) in 32 patients who did not receive ZA and were on ADT (p <0.05). Pain scores significantly decreased in patients after 12-months of ZA use (−2.92±2.16, p <0.01). Conclusion: Bone-directed therapy (Zoledronic acid) leads to both subjective and objective improvement in bone health of prostate cancer patients on ADT.
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Gupta A, Gahlot N, Elhence P. Complete paraplegia with diffuse osteolytic skeletal metastases: an uncommon presentation of carcinoma of the prostate. Spinal Cord Ser Cases 2020; 6:25. [PMID: 32321926 DOI: 10.1038/s41394-020-0276-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2020] [Revised: 03/22/2020] [Accepted: 03/22/2020] [Indexed: 12/20/2022] Open
Abstract
INTRODUCTION Skeletal metastases of advanced prostatic cancer are usually osteoblastic in appearance. Osteolytic secondaries are an uncommon entity. In such scenarios, it is important to differentiate prostatic metastases from other pathologies which give an identical radiological appearance, such as multiple myeloma. Another important point to remember is that neurological complications secondary to prostatic metastases are quite uncommon. CASE PRESENTATION We describe a man with advanced prostatic carcinoma who presented to us with an uncommon combination of sudden onset complete paraplegia associated with diminished sensation in the lower half of the body and diffuse osteolytic lesions in the entire skeletal system. On detailed workup, it was found that his prostatic specific antigen (PSA) was grossly elevated. Markers for multiple myeloma were negative. Accordingly, computerized tomography of the abdomen was performed. The latter revealed an enlarged prostate gland infiltrating into the bladder base. Histopathological analysis from the prostate as well as the bone marrow showed an identical picture thereby confirming our diagnosis. The individual underwent palliative spinal canal decompression following which he was put on anti-androgenic treatment. At one year follow up, he was ambulatory and able to walk with use of crutches. DISCUSSION To the best of our knowledge, this is the first reported case of osteolytic prostatic metastases presenting as complete paraplegia. In this situation, in addition to evaluation for prostate CA, we also recommend screening for multiple myeloma as the clinico-radiological profile of the two diseases are similar but their management is very different.
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Affiliation(s)
- Akshat Gupta
- Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
| | - Nitesh Gahlot
- Department of Orthopaedics, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India.
| | - Poonam Elhence
- Department of Pathology, All India Institute of Medical Sciences, Jodhpur, Rajasthan, 342005, India
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Tanaka T, Yang M, Froemming AT, Bryce AH, Inai R, Kanazawa S, Kawashima A. Current Imaging Techniques for and Imaging Spectrum of Prostate Cancer Recurrence and Metastasis: A Pictorial Review. Radiographics 2020; 40:709-726. [PMID: 32196428 DOI: 10.1148/rg.2020190121] [Citation(s) in RCA: 37] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Relapsing level of prostate-specific antigen (PSA) after initial curative-intent local therapy for organ-confined prostate cancer is often the first sign of recurrence. However, PSA level recurrence does not enable accurate differentiation of locally recurrent tumor from metastatic disease or a combination of both. Metastatic prostate cancer most frequently involves bones and lymph nodes, followed by other organs such as the liver, lung, pleura, adrenal gland, ureter, peritoneum, penis, testis, and meninges. Conventional imaging including CT and bone scintigraphy has long been the standard of care but has limited sensitivity in depicting early local recurrence or metastatic disease. Multiparametric MRI has been shown to be more sensitive in detecting locally recurrent tumor in the prostatectomy bed as well as in situ recurrence in a prostate gland that has been treated with radiation therapy or thermal ablation. In addition, lesions detected with multiparametric MRI may be amenable to targeted biopsy for definitive diagnosis of recurrence. PET/CT or PET/MRI using the U.S. Food and Drug Administration (FDA)-approved tracers carbon 11 choline or fluorine 18 fluciclovine has demonstrated markedly increased sensitivity and specificity for diagnosis of early metastatic disease such as small-volume lymph node metastasis, as have a range of investigational gallium 68 prostate-specific membrane antigen (PSMA) radioactive PET tracers. With recent advances in imaging modalities and techniques, more accurate early detection, localization, and characterization of recurrent prostate cancer have become possible. The authors present a contemporary review of the strengths and limitations of conventional and advanced imaging modalities in evaluation of patients with recurrent prostate cancer and a systematic review of the clinical and imaging features of locally recurrent and metastatic disease.©RSNA, 2020See discussion on this article by Barwick and Castellucci.
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Affiliation(s)
- Takashi Tanaka
- From the Department of Radiology (T.T., M.Y., A.K.) and Department of Hematology and Medical Oncology (A.H.B.), Mayo Clinic, Scottsdale, Ariz; Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan (T.T., R.I., S.K.); and Department of Radiology, Mayo Clinic, Rochester, Minn (A.T.F.)
| | - Ming Yang
- From the Department of Radiology (T.T., M.Y., A.K.) and Department of Hematology and Medical Oncology (A.H.B.), Mayo Clinic, Scottsdale, Ariz; Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan (T.T., R.I., S.K.); and Department of Radiology, Mayo Clinic, Rochester, Minn (A.T.F.)
| | - Adam T Froemming
- From the Department of Radiology (T.T., M.Y., A.K.) and Department of Hematology and Medical Oncology (A.H.B.), Mayo Clinic, Scottsdale, Ariz; Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan (T.T., R.I., S.K.); and Department of Radiology, Mayo Clinic, Rochester, Minn (A.T.F.)
| | - Alan H Bryce
- From the Department of Radiology (T.T., M.Y., A.K.) and Department of Hematology and Medical Oncology (A.H.B.), Mayo Clinic, Scottsdale, Ariz; Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan (T.T., R.I., S.K.); and Department of Radiology, Mayo Clinic, Rochester, Minn (A.T.F.)
| | - Ryota Inai
- From the Department of Radiology (T.T., M.Y., A.K.) and Department of Hematology and Medical Oncology (A.H.B.), Mayo Clinic, Scottsdale, Ariz; Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan (T.T., R.I., S.K.); and Department of Radiology, Mayo Clinic, Rochester, Minn (A.T.F.)
| | - Susumu Kanazawa
- From the Department of Radiology (T.T., M.Y., A.K.) and Department of Hematology and Medical Oncology (A.H.B.), Mayo Clinic, Scottsdale, Ariz; Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan (T.T., R.I., S.K.); and Department of Radiology, Mayo Clinic, Rochester, Minn (A.T.F.)
| | - Akira Kawashima
- From the Department of Radiology (T.T., M.Y., A.K.) and Department of Hematology and Medical Oncology (A.H.B.), Mayo Clinic, Scottsdale, Ariz; Department of Radiology, Okayama University Hospital, 2-5-1 Shikata-cho, Okayama 700-8558, Japan (T.T., R.I., S.K.); and Department of Radiology, Mayo Clinic, Rochester, Minn (A.T.F.)
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Wu LX, Lei L, Zhu YC, Du KQ, Li XF, Chen HF, Wang WX, Xu CW. A prostate cancer patient with isolated lung metastases: a case report. Transl Cancer Res 2020; 9:2064-2068. [PMID: 35117556 PMCID: PMC8798257 DOI: 10.21037/tcr.2020.01.19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2019] [Accepted: 01/06/2020] [Indexed: 11/25/2022]
Abstract
Pulmonary involvement has been reported in >40% of autopsy series in patients with metastatic prostate cancer; however, isolated lung metastases have been documented in <1% of cases and 43.5% (10/23) cases underwent surgical resection and most of them have good outcome. We present a 74-year-old male Gleason high-grade prostate cancer patient with initially negative PSA and isolated pulmonary lesion which was confirmed as lung metastasis by resection. This patient received first-line endocrine therapy with leuprolide and bicalutamide endocrine and had a long-term disease-free follow-up of 3 years. The present patient had isolated lung metastasis with negative PSA, which was very rare in literature. Unexpected long-term disease-free survival was achieved after first-line endocrine therapy in this case with Gleason score of 8 metastatic prostate cancer. Whether or not the path of metastasis in this case was via lymph node jumping (negative lymph node dissection) or hematogenous (usually multiple, in bilateral lungs and lower lung fields) requires further investigation.
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Affiliation(s)
- Li-Xin Wu
- Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, The Third Affiliated Hospital of Jiaxing University, Jiaxing 314000, China
| | - Lei Lei
- Department of Chemotherapy, Chinese Academy of Sciences University Cancer Hospital (Zhejiang Cancer Hospital), Hangzhou 310022, China
| | - You-Cai Zhu
- Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, The Third Affiliated Hospital of Jiaxing University, Jiaxing 314000, China
| | - Kai-Qi Du
- Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, The Third Affiliated Hospital of Jiaxing University, Jiaxing 314000, China
| | - Xiao-Feng Li
- Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, The Third Affiliated Hospital of Jiaxing University, Jiaxing 314000, China
| | - Hua-Fei Chen
- Department of Thoracic Disease Center, Zhejiang Rongjun Hospital, The Third Affiliated Hospital of Jiaxing University, Jiaxing 314000, China
| | - Wen-Xian Wang
- Department of Chemotherapy, Chinese Academy of Sciences University Cancer Hospital (Zhejiang Cancer Hospital), Hangzhou 310022, China
| | - Chun-Wei Xu
- Department of Respiratory Medicine, Jinling Hospital, Nanjing University School of Medicine, Nanjing 210002, China
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Extraprostatic Uptake of 18F-Fluciclovine: Differentiation of Nonprostatic Neoplasms From Metastatic Prostate Cancer. AJR Am J Roentgenol 2020; 214:641-648. [PMID: 31939697 DOI: 10.2214/ajr.19.21894] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
OBJECTIVE. Fluciclovine is a synthetic radiolabeled amino acid analog used for imaging of biochemical recurrent prostate cancer. Uptake of fluciclovine is mediated by several amino acid transporters, including alanine-serine-cysteine transporter 2 and large neutral amino acid transporters, which are known to be overexpressed in other malignancies. CONCLUSION. Knowledge of the common patterns of prostate cancer recurrence, in addition to what other neoplasms can show uptake, is critical for accurate study interpretation.
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Cui PF, Cong XF, Gao F, Yin JX, Niu ZR, Zhao SC, Liu ZL. Prognostic factors for overall survival in prostate cancer patients with different site-specific visceral metastases: A study of 1358 patients. World J Clin Cases 2020; 8:54-67. [PMID: 31970170 PMCID: PMC6962083 DOI: 10.12998/wjcc.v8.i1.54] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2019] [Revised: 12/09/2019] [Accepted: 12/14/2019] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Distant metastasis, particularly visceral metastasis (VM), represents an important negative prognostic factor for prostate cancer (PCa) patients. However, due to the lower rate of occurrence of VM, studies on these patients are relatively rare. Consequently, studies focusing on prognostic factors associated with PCa patients with VM are highly desirable. AIM To investigate the prognostic factors for overall survival (OS) in PCa patients with lung, brain, and liver metastases, respectively, and evaluate the impact of site-specific and number-specific VM on OS. METHODS Data on PCa patients with VM were extracted from the Surveillance, Epidemiology, and End Results database between 2010 and 2015. Univariate and multivariate Cox regression analyses were used to analyze the association between clinicopathological characteristics and survival of patients with different site-specific VM. Kaplan-Meier analyses and Log-rank tests were performed to analyze the differences among the groups. RESULTS A total of 1358 PCa patients with site-specific VM were identified from 2010 to 2015. Older age (> 70 years) (P < 0.001), higher stage (T3/T4) (P = 0.004), and higher Gleason score (> 8) (P < 0.001) were found to be significant independent prognostic factors associated with poor OS in PCa patients with lung metastases. Higher stage (T3/T4) (P = 0.047) was noted to be the only independent risk factor affecting OS in PCa patients with brain metastases. Older age (> 70 years) (P = 0.010) and higher Gleason score (> 8) (P = 0.001) were associated with shorter OS in PCa patients with liver metastases. PCa patients with isolated lung metastases exhibited significantly better survival outcomes compared with PCa patients with other single sites of VM (P < 0.001). PCa patients with a single site of VM exhibited a superior OS compared with PCa patients with multiple sites of VM (P < 0.001). CONCLUSION This is the first Surveillance, Epidemiology, and End Results-based study to determine prognostic factors affecting OS in PCa patients with different site-specific VM. Clinical assessments of these crucial prognostic factors become necessary before establishing a treatment strategy for these patients with metastatic PCa.
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Affiliation(s)
- Peng-Fei Cui
- Cancer Center, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Xiao-Feng Cong
- Cancer Center, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Feng Gao
- Cancer Center, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Jia-Xin Yin
- Cancer Center, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Zi-Ru Niu
- Cancer Center, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Song-Chen Zhao
- Cancer Center, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
| | - Zi-Ling Liu
- Cancer Center, the First Hospital of Jilin University, Changchun 130021, Jilin Province, China
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Pudova EA, Lukyanova EN, Nyushko KM, Mikhaylenko DS, Zaretsky AR, Snezhkina AV, Savvateeva MV, Kobelyatskaya AA, Melnikova NV, Volchenko NN, Efremov GD, Klimina KM, Belova AA, Kiseleva MV, Kaprin AD, Alekseev BY, Krasnov GS, Kudryavtseva AV. Differentially Expressed Genes Associated With Prognosis in Locally Advanced Lymph Node-Negative Prostate Cancer. Front Genet 2019; 10:730. [PMID: 31447885 PMCID: PMC6697060 DOI: 10.3389/fgene.2019.00730] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 07/11/2019] [Indexed: 12/14/2022] Open
Abstract
Older age is one of the main risk factors for cancer development. The incidence of prostate cancer, as a multifactorial disease, also depends upon demographic factors, race, and genetic predisposition. Prostate cancer most frequently occurs in men over 60 years of age, indicating a clear association between older age and disease onset. Carcinogenesis is followed by the deregulation of many genes, and some of these changes could serve as biomarkers for diagnosis, prognosis, prediction of drug therapy efficacy, as well as possible therapeutic targets. We have performed a bioinformatic analysis of a The Cancer Genome Atlas (TCGA) data and RNA-Seq profiling of a Russian patient cohort to reveal prognostic markers of locally advanced lymph node-negative prostate cancer (lymph node-negative LAPC). We also aimed to identify markers of the most common molecular subtype of prostate cancer carrying a fusion transcript TMPRSS2-ERG. We have found several genes that were differently expressed between the favorable and unfavorable prognosis groups and involved in the enriched KEGG pathways based on the TCGA (B4GALNT4, PTK6, and CHAT) and Russian patient cohort data (AKR1C1 and AKR1C3). Additionally, we revealed such genes for the TMPRSS2-ERG prostate cancer molecular subtype (B4GALNT4, ASRGL1, MYBPC1, RGS11, SLC6A14, GALNT13, and ST6GALNAC1). Obtained results contribute to a better understanding of the molecular mechanisms behind prostate cancer progression and could be used for further development of the LAPC prognosis marker panel.
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Affiliation(s)
- Elena A. Pudova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Elena N. Lukyanova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Kirill M. Nyushko
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Dmitry S. Mikhaylenko
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
- Federal State Autonomous Educational Institution of Higher Education, I.M. Sechenov First Moscow State Medical University of the Ministry of Health of the Russian Federation, Moscow, Russia
| | - Andrew R. Zaretsky
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | | | - Maria V. Savvateeva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | | | - Nataliya V. Melnikova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Nadezhda N. Volchenko
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Gennady D. Efremov
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Kseniya M. Klimina
- Vavilov Institute of General Genetics, Russian Academy of Sciences, Moscow, Russia
| | - Anastasiya A. Belova
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Marina V. Kiseleva
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Andrey D. Kaprin
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - Boris Y. Alekseev
- National Medical Research Radiological Center, Ministry of Health of the Russian Federation, Moscow, Russia
| | - George S. Krasnov
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
| | - Anna V. Kudryavtseva
- Engelhardt Institute of Molecular Biology, Russian Academy of Sciences, Moscow, Russia
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Thoracic Manifestations of Genitourinary Neoplasms and Treatment-related Complications. J Thorac Imaging 2019; 34:W36-W48. [PMID: 31009398 DOI: 10.1097/rti.0000000000000382] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Genitourinary (GU) malignancies are a diverse group of common and uncommon neoplasms that may be associated with significant mortality. Metastases from GU neoplasms are frequently encountered in the chest, and virtually all thoracic structures can be involved. Although the most common imaging manifestations include hematogenous dissemination manifesting with peripheral predominant bilateral pulmonary nodules and lymphatic metastases manifesting with mediastinal and hilar lymphadenopathy, some GU malignancies exhibit unique features. We review the general patterns, pathways, and thoracic imaging features of renal, adrenal, urothelial, prostatic, and testicular metastatic neoplasms, as well as provide a discussion of treatment-related complications that might manifest in the chest. Detailed reporting of these patterns will allow the imager to assist the referring clinicians and surgeons in accurate determination of the stage, prognosis, and treatment options available for the patient. Awareness of specific treatment-related complications further allows the imager to enhance patient safety through accurate and timely reporting of potentially life-threatening consequences of therapies.
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