Leptomeningeal involvement by prostate carcinoma an ominous head of a well-known Hydra
| Autor: | Fady Tawadros, Sukesh Manthri, Maria Zayko, Kanishka Chakraborty |
|---|---|
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Vomiting Nausea medicine.medical_treatment Unusual Association of Diseases/Symptoms Bone Neoplasms Diagnosis Differential Androgen deprivation therapy 03 medical and health sciences chemistry.chemical_compound Fatal Outcome 0302 clinical medicine Antineoplastic Combined Chemotherapy Protocols Biopsy Meningeal Neoplasms medicine Humans Enzalutamide 030212 general & internal medicine Pelvic Bones Aged medicine.diagnostic_test Lumbar puncture business.industry Prostatectomy General Medicine Prostatic Neoplasms Castration-Resistant chemistry Docetaxel 030220 oncology & carcinogenesis Radiotherapy Adjuvant Radiology medicine.symptom business medicine.drug |
| Zdroj: | BMJ Case Rep |
| ISSN: | 1757-790X |
| Popis: | A 67-year-old male patient presents to the hospital complaining of severe nausea and vomiting failing oral antiemetics. He carries the history of initial diagnosis of stage III prostate cancer. He underwent radical prostatectomy followed by external beam radiation. After 5 years of initial excellent control with androgen deprivation therapy (ADT), imaging study showed retroperitoneal adenopathy denoting ADT failure. His prostate-specific antigen continued to rise while on enzalutamide and then abiraterone reflecting disease progression. He maintained excellent functional capacity through 23 cycles of docetaxel however he started developing hip pain after the last cycle with imaging studies suggesting new hip metastatic disease. Following the first cycle of radium-223, the patient presented with intractable nausea and vomiting. MRI showed a high suspicion of leptomeningeal spread which was confirmed through a meningeal biopsy after lumbar puncture showed negative results. The patient had excellent symptomatic response to high-dose dexamethasone. After receiving whole-brain radiation, the patient opted to be on best supportive care and succumbed to his illness 3 months later. |
| Databáze: | OpenAIRE |
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