Prostate-specific antigen in the cerebrospinal fluid leads to diagnosis of solitary cauda equina metastasis: a unique case report and review of the literature

British Journal of Cancer
B SchallerO Gratzl

Abstract

A 79-year-old male patient presented with a subacute cauda syndrome caused by an intradural metastasis of the lumbosacral caudate fibres from an adenocarcinoma of the prostate, which had been treated 5 years earlier with external beam radiation therapy. Diagnosis could not be established by repeated magnetic resonance images (MRIs) during a 2-year period of increasingly severe radicular pain. Eventually, a small tumour mass could be visualized on the fourth MRI. Repeated normal serum prostate-specific antigen (PSA) did not hint at a prostate cancer metastasis (range 2.4-5.1 ng ml(-1)); however, PSA in the cerebrospinal fluid was found to be elevated (29.1 ng ml(-1)). Empirical radiation therapy of the caudate region did not improve radicular pain. Therefore, an exploratory surgical procedure was conducted, which confirmed the suspicion of an intradural prostate cancer metastasis. In conclusion, PSA in the cerebrospinal fluid provides a useful diagnostic tool for detecting intradural prostate cancer metastasis.

Citations

Apr 9, 2004·Journal of Neurosurgery·Stephen J HentschelLaurence D Rhines
Dec 20, 2005·International Urology and Nephrology·Hayrettin SahinMehmet Kamuran Bircan
Jun 5, 2012·Journal of Medical Case Reports·Robert E LiebersonSteven D Chang
Oct 3, 2008·Medical Oncology·George OrphanosGeorge Kitrou
Nov 12, 2009·Clinical & Experimental Metastasis·George Orphanos, Alexandros Ardavanis
May 11, 2016·The Canadian Journal of Neurological Sciences. Le Journal Canadien Des Sciences Neurologiques·Amparo WolfFawaz Siddiqi
Nov 17, 2020·Journal of Community Hospital Internal Medicine Perspectives·Suhu LiuStephen Jesmajian
Sep 5, 2009·Annals of Clinical Biochemistry·Sandra D MulderRobert Veerhuis
Aug 1, 2021·British Journal of Neurosurgery·Andrea PaganoMurizio Salvati

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