Metastatic prostatic adenocarcinoma to the brain and spinal cord: a contemporary clinicopathologic analysis of 30 cases.

• Type of Material: Article
• Authors: Oluwaseun B. Ogunbona, Emory University; Abigail L. Goodman, Emory University; Adeboye O. Osunkoya, Emory University
• Language: English
• Date: 2021
• Publisher: e-Century Publishing
• Publication Version: Final Published Version
• Copyright Statement: © 2021 IJCEP
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Title of Journal or Parent Work: International Journal of Clinical & Experimental Pathology
• Volume: 14
• Issue: 1
• Start Page: 45
• End Page: 53
• Grant/Funding Information: None declared
• Keywords: Prostatic adenocarcinoma; spinal cord; brain; metastasis
• Research Categories: Health Sciences, Pathology; Biology, Neuroscience; Health Sciences, Oncology

Abstract

Metastatic prostatic adenocarcinoma (PCa) to lymph nodes and bone is well documented in the literature, however only case reports and small series of metastatic PCa to the brain and spinal cord with clinicopathologic analysis have been published. We identified 30 cases of metastatic PCa to the brain and spinal cord. The mean patient age was 67 years (range: 50 to 87 years). Thirteen (43%) cases involved the brain and 17 (57%) cases involved the spinal cord. Most of the cases (60%) were a single mass. Of the 13 cases involving the brain, the temporal lobe 6 (46%) was the most common site and the spinal cord lesions involved the thoracic region in 13/17 (76%) cases. All patients had one or more metastases to other organs. In 8 patients, the brain or spinal cord metastasis was the initial diagnosis of PCa. In the patients that had prior prostate biopsy specimens available, the Gleason score ranged from 3+3=6 (Grade group 1: indicating unsampled higher grade PCa) to Gleason score 4+5=9 (Grade group 5). Follow-up was available in 21 cases with a mean duration of 20 months (range: 1 to 130 months). This is one of the largest clinicopathologic studies to date of metastatic PCa to the brain and spinal cord. Although rare, metastatic PCa should be considered in the differential diagnosis of a solitary brain or spinal cord mass in male patients, even over a decade after the initial diagnosis of PCa.