Aim: Our main study focus was to evaluate the incidence, imaging characteristics, and prognosis of parenchymal brain metastases originating from prostatic tumors.
Introduction: Prostate cancer is considered the second most commonly diagnosed cancer.1 In addition, it is considered the fifth leading cause of cancer death amongst males.2 A small percentage (2%) of patients with prostate cancer are found to be castrate-resistant and to develop brain metastasis, a rare complication which is associated to an advanced systemic state of the disease when the tumor has already spread to other sites.3 Although, there is not much evidence on optimal management of these patients.4
Methods: A review of case records of prostate cancer patients within the IPO Porto data base from 2013 to 2015 was conducted in order to identify the patients with prostate cancer and evidence of brain metastases. As criteria of exclusion, cases transferred to other hospitals without follow up and cases that were incorrectly categorized were excluded.
Results: We screened 2194 patients with prostate cancer, with only one having evidence of brain metastasis. Additionally, one case was identified with bilateral orbital metastatic lesions. The patient with evidence of brain metastasis aged 48 years old. Magnetic resonance imaging showed six metastatic lesions, three infratentorial and three supratentorial. The largest lesion was found in the parieto-occipital region. These brain metastasis were detected 42 months after the initial diagnosis of prostate adenocarcinoma. In addition, by the time of brain metastasis detection, the patient already had bone metastatic lesion.
Conclusion: Brain metastases from prostate cancer are rare, with only a few cases described in the literature. Variable magnetic resonance imaging characteristics are described. Brain metastases are also associated with a poor prognosis, with a mean survival of 1–7.6 months.