Isolated Lung Metastasis Prostate Cancer

Abstract

Introduction and importance: Prostate cancer is the second most diagnosed malignancy (after lung cancer) in men worldwide. The most common site for metastasis of prostate cancer is bone (84%), followed by distant lymph nodes (10.6%), liver (10.2%), and lung being the least with 9.1%. Isolated lung metastasis is very rare and is present in less than 4.6% of metastatic prostate cancer. This is the first case of de novo isolated lung metastasis of prostate cancer in our setting.

Case presentation: We report a case of an 81-year-old male of African ethnicity who was diagnosed with isolated lung metastasis prostate adenocarcinoma. The total prostate specific antigen at the time of diagnosis was 182 ng/ml and grade group 3.

Clinical discussion: The prognosis of prostate cancer patients with pulmonary metastasis is reported to be limited. Prostate cancer patients with lung metastasis have median overall survival of approximately 19 months.

Conclusion: Although isolated pulmonary metastasis is rare in prostate cancer, it should not be excluded especially in patients with perineural invasion; however, further investigations are required to exclude metastasis to other sites.

Keywords: lung metastasis; palliative care; pathology; prostate cancer.

Figure 1.

Time line of important events.

Figure 2.

Chest X-ray in posterior aterior view. Homogenous opacity obliterating the right costophrenic angle with reduced right lung volume on the right hemi-thorax.

Figures 3a and b:

Chest CT scan; Axial and sagittal reformatted sections of chest at the level of the consolidation. Right lower lobe posterior basal segment consolidation (6.07 × 4.25) cm with no air broncograms associated with mild right pleural effusion.

Figure 4.

Large pleomorphic cells with abundant cytoplasm, few mesothelial cells, and lymphocytes.

Figure 5.

Infiltrates of atypical poorly formed and fused glands forming nests with peri neural invasion.