Cutaneous metastasis in prostatic carcinoma

Cutaneous Metastasis From Prostate Cancer on Posttherapeutic 177 Lu-Prostate-Specific Membrane Antigen Scan

ABSTRACT

In this note, we aim to present a patient with a known case of prostate cancer with widespread metastasis to the skeleton and liver who has undergone several cycles of chemoradiotherapy. The patient received 2 doses of 177 Lu-prostate-specific membrane antigen therapy, in which several zones of uptake were detected on the thoracic wall compatible with cutaneous metastatic lesions of prostate cancer.

Prostate adenocarcinoma and cutaneous metastases

Prostate cancer is the second most frequently diagnosed cancer in men and the fifth leading cause of mortality worldwide. Men of African descent with prostate adenocarcinoma tend to present late with advanced, aggressive and often metastatic disease. Cutaneous metastases are extremely rare, with the incidence reported to be as low as 0.36%. We report a case of prostate adenocarcinoma with cutaneous metastases. A 69-year-old African male known to the urology unit, with metastatic adenocarcinoma of the prostate, presented with a two-week history of pale-to-purple large nodular lesions on the skin of his left hemiscrotum and smaller nodules on the penile shaft. Punch biopsies of the scrotal nodules revealed metastatic prostate adenocarcinoma. Bilateral orchidectomy and excision of the cutaneous lesions were performed. Although cutaneous metastases are rare, more so in patients with adenocarcinoma of the prostate, any skin lesions in patients with a known primary malignancy should raise a suspicion of metastasis. All physicians should therefore have a low threshold for the biopsy of any unusual skin lesion in patients with known prostate cancer.

Level of evidence: 5.

A Case of Prostatic Carcinoma Manifesting as Cutaneous Facial Nodule

Prostate cancer is the second most frequently diagnosed cancer worldwide and the fifth most common cause of cancer deaths among men. Cutaneous metastasis is an uncommon phenomenon in prostatic cancer, occurring in 0.06-0.3% of cases. Case Presentation. A 56-year-old man presented to our outpatient clinic with a one-month history of a 1.5 cm in diameter, solitary, asymptomatic, purple nodule located on his upper right cheek. After biopsy, prostatic cancer metastasis was diagnosed. Discussion. A literature review revealed 59 articles documenting 71 cases of this diagnosis. The review recorded epidemiological data, including age, duration, morphology, location, and outcome of patients. Conclusions. The skin is an uncommon site for metastasis of prostate cancer, and the review showed that its presence is associated with a poor prognosis (approximately 10 months from diagnosis).

Cutaneous metastases of prostatic adenocarcinoma

Prostatic adenocarcinoma (PA) is a common visceral malignancy of elderly men. Cutaneous metastasis of PA is rare. The incidence is <1%. A 55-year-old man presented with urinary symptoms and multiple cutaneous nodules around suprapubic region, inner aspect of both thighs and scrotum. Fine-needle aspiration cytology (FNAC) of cutaneous nodules was suggestive of metastatic adenocarcinoma. Skin and prostatic biopsies confirmed the cytological diagnosis. Serum level of prostate specific antigen was raised. Total prostatectomy revealed adenocarcinoma of Gleason's score 7 (3 + 4). Though rare, cutaneous metastases of PA must be known to cytopathologists. Meticulously performed FNAC in such cases may help in early diagnosis.

Tumor attributes predicting cutaneous metastatic destiny: a report of two interesting cases

Cutaneous metastases are the result of complex interaction between the tumor cells ("seed") and the host environment ("soil"). Metastases to the skin can be an early sign of internal malignancy or represent recurrence of the primary tumor and portends a poorer prognosis. Invasion and metastasis are the hallmarks of on cogenesis. Skin is the largest organ in the body, but the incidence of metastases is low. With advances in molecular biology, factors responsible for the initiation and perpetuation of metastatic tumor cells at distant sites are being elucidated. The concept of "pre-metastatic niche" and interaction between various chemokines has given a new outlook in understanding the organ specificity of metastatic tumor cells. We present two cases of cutaneous metastases with interesting clinical findings correlating with its biologic subtypes.