scholarly journals Prostate cancer presented with de novo brain metastases as initial manifestation: A case report with review of the literature

2021 ◽  
Vol 5 (1) ◽  
pp. 01-04
Author(s):  
Konstantinos Tsapakidis
Keyword(s):  
Prostate Cancer ◽  
Brain Metastases ◽  
De Novo ◽  
Clinical Symptoms ◽  
Neurological Symptoms ◽  
Review Of The Literature ◽  
Initial Manifestation ◽  
Common Cancer ◽  
Advanced Stages ◽  
Prostate Cancers

Prostate cancer is the most common cancer and among the leading causes of cancer death in men and its clinical symptoms vary a lot. The most common metastatic site is the bones, but rarely prostate cancer can metastasize to brain in very advanced stages of the disease. However, brain metastases giving neurological symptoms as first manifestation of prostate cancers have been reported. Research of international literature revealed only seventeen patients (including our own) that were diagnosed with prostate cancer presented with neurological symptoms.

SPOP mutations in prostate cancer: Clinical and genomic features.

2021 ◽  
Vol 39 (6_suppl) ◽  
pp. 151-151
Author(s):  
Mari Nakazawa ◽  
Mike Fang ◽  
Pedro Issacsson Velho ◽  
Emmanuel S. Antonarakis
Keyword(s):  
Prostate Cancer ◽  
Clinical Outcomes ◽  
Metastatic Disease ◽  
Wnt Pathway ◽  
Zinc Finger Protein ◽  
De Novo ◽  
First Line ◽  
Primary Tumors ◽  
Pathway Activation ◽  
Prostate Cancers

151 Background: Point mutations in the gene encoding speckle-type pox virus and zinc finger protein (SPOP) are the most frequently identified mutations in prostate cancer, occurring at a frequency of 6-15% across localized and disseminated cancers. Recently, SPOP gene alterations have gained attention as they appear to define a novel subclass of prostate cancers. Previous studies show that patients with mutant SPOP (mtSPOP) had superior responses to androgen deprivation therapy (ADT) and exhibit more favorable responses to abiraterone compared to wild type SPOP (wtSPOP). Methods: We retrospectively identified 59 prostate cancer patients at a single institution (Johns Hopkins) with somatic SPOP mutations from genomic testing of primary tumors (n=45), metastatic lesions (n=12), or liquid biopsies (n=2). Patient records were reviewed to determine baseline characteristics, therapies received, and clinical outcomes. The primary outcomes included best PSA response and progression-free survival (PFS) on ADT in the hormone sensitive prostate cancer (HSPC) setting and on abiraterone and/or enzalutamide in the first-line castration resistant prostate cancer (CRPC) setting. PFS was defined as either PSA, radiographic, or clinical progression. Results: The median age at diagnosis was 64 years (range 46 to 85). 17/59 (28.8%) were Black. F133 was the most frequently mutated residue, occurring in 33 (55.9%) instances (Table). There were two patients who harbored two mutations in the SPOP gene. The most frequently co-occurring mutation was in APC (15/59 [25.4%] patients), resulting in Wnt pathway activation. Concurrent ERG fusions were not observed with this cohort (0/59 [0%] patients). 41/59 (69.4%) were diagnosed with Gleason 8-10 disease. 21/59 (35.5%) were diagnosed with de novo metastatic disease. 50/59 (84.7%) patients received ADT for recurrent or metastatic disease. Median PFS on ADT was 40.7 (95% CI 23.4-71.9) months. Of the 27/59 (45.8%) patients who progressed to CRPC, 20/59 (33.9%) patients received abiraterone and 13/59 (22.0%) received enzalutamide; 9/59 (15.3%) patients received both agents. Median PFS was 7.8 (95% CI 6.7-NR) months on abiraterone and 7.3 (95% CI 3.2-NR) months on enzalutamide. Other notable therapies received in the CRPC setting include docetaxel (5/59 [8.5%] patients), cabazitaxel (5/59 [8.5%] patients), and PARP inhibitor olaparib or rucaparib (4/59 [6.8%] patients). Conclusions: SPOP mutations define a unique subset of prostate cancers enriched for black patients, high Gleason scores, absence of ERG fusions, and Wnt pathway activation. Clinical outcomes to first-line ADT appear longer than expected for genomically-unselected patients. [Table: see text]

scholarly journals Epigenetic Control of Gene Expression in the Normal and Malignant Human Prostate: A Rapid Response Which Promotes Therapeutic Resistance

2019 ◽  
Vol 20 (10) ◽  
pp. 2437 ◽  
Author(s):  
Fiona M. Frame ◽  
Norman J. Maitland
Keyword(s):  
Prostate Cancer ◽  
De Novo ◽  
Individual Cell ◽  
Treatment Resistance ◽  
Human Prostate ◽  
De Novo Mutations ◽  
Control Of Gene Expression ◽  
Prostate Cancers ◽  
Cell Phenotypes ◽  
Relapse Rates

A successful prostate cancer must be capable of changing its phenotype in response to a variety of microenvironmental influences, such as adaptation to treatment or successful proliferation at a particular metastatic site. New cell phenotypes emerge by selection from the large, genotypically heterogeneous pool of candidate cells present within any tumor mass, including a distinct stem cell-like population. In such a multicellular model of human prostate cancer, flexible responses are primarily governed not only by de novo mutations but appear to be dominated by a combination of epigenetic controls, whose application results in treatment resistance and tumor relapse. Detailed studies of these individual cell populations have resulted in an epigenetic model for epithelial cell differentiation, which is also instructive in explaining the reported high and inevitable relapse rates of human prostate cancers to a multitude of treatment types.

Aggressive variant prostate cancer (AVPC) molecular signature in castration-sensitive, de novo metastatic prostate cancer (M1PCa).

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. 5052-5052
Author(s):  
Ana Aparicio ◽  
Miao Zhang ◽  
Naveen Ramesh ◽  
Xuemei Wang ◽  
Paul Gettys Corn ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
De Novo ◽  
Local Therapy ◽  
Progression Free Survival ◽  
Outcome Data ◽  
Molecular Signature ◽  
Castration Resistant Prostate Cancer ◽  
Therapeutic Implications ◽  
Prostate Cancers ◽  
Prostate Carcinomas

5052 Background: AVPC are a subset of prostate cancers (PC) that share clinical features with the small-cell prostate carcinomas, a rare morphological variant with atypical and virulent behavior. They are estimated to represent 30% of lethal PC and are characterized by a molecular signature of combined defects (≥2) in Tp53, RB1 and PTEN (AVPC_MS). The AVPC_MS is associated with androgen indifference in preclinical models and predicts for benefit from the addition of carboplatin to cabazitaxel in men with castration resistant prostate cancer (CRPC). The prevalence and significance of the AVPC_MS in castration sensitive M1PC is unknown. Methods: In a Phase II trial 119 men with M1PC treated with 6 months of standard systemic therapy (SST) were randomized to the addition of local therapy. PCa samples obtained at diagnosis and after 6 months of SST were stained for markers including Tp53, RB1 and PTEN, and subject to whole genome sequencing. Tp53 was considered defective if expressed in ≥ 10% of tumor cells, and RB1 and PTEN if in ≤ 10%. Progression free survival (PFS) was estimated from SST start. Results: To date specimens from 38 men have been evaluated. Immunohistochemistry (IHC) results are shown below. The median PFS of men with AVPC_MSPOSITIVE vs AVPC_MSNEGATIVEbaseline prostate tumors was 9.3 vs 15 months (HR 1.09, 95%CI 0.42-2.87, P=0.852). Conclusions: The rate at which the AVPC molecular signature is detected in castration sensitive M1PCa appears similar to that in CRPC. This may have therapeutic implications. Updated molecular and outcome data will be presented upon acceptance. [Table: see text]

Brain and meningeal metastases (BMm) from castration-resistant prostate cancer (CRPC) in the era of docetaxel (DOC).

2011 ◽  
Vol 29 (7_suppl) ◽  
pp. 217-217
Author(s):  
O. Caffo ◽  
A. Gernone ◽  
C. Ortega ◽  
T. Sava ◽  
G. Carteni ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Brain Metastases ◽  
Median Number ◽  
Best Supportive Care ◽  
Neurological Symptoms ◽  
Castration Resistant Prostate Cancer ◽  
Brain Irradiation ◽  
Historical Series ◽  
Clinical Records

217 Background: The occurrence of BMm is usually viewed as an exceptional event in the history of prostate cancer (PC) patients (pts). In two large retrospective series the incidence of BMm in PC pts was about 0.5%. Since the introduction of DOC as first line treatment has improved survival of CRPC pts, we have retrospectively evaluated the occurrence of BMm in such setting of pts, to explore whether the incidence of BMm has changed. Methods: The clinical records of a series of 801 pts with CRPC treated from 2002 to 2010 were reviewed. All pts met the definition of CRPC according to international guidelines: all pts received or were eligible for DOC-based treatment. Results: We collected a series of 28 pts with BMm (incidence 2.9%). Sixteen pts had a median number of 1 brain metastases (range 1-8) and neurological symptoms were present in 11 cases. Teen cases presented meningeal metastases: in this case all but one pt were symptomatic. To date, no detailed information are available for the 2 remaining cases. After BMm diagnosis, local treatments were proposed in 16 pts: 5 pts underwent metastasectomy (M) + external brain irradiation (BI), 1 M alone, 9 BI alone, 1 gamma-knife. Eleven pts received chemotherapy after BMm, while the remaining received only best supportive care. The median interval from the PC diagnosis and the achievement of CRPC was 23 mos (range 7-141) while the appearance of BMm was documented after 6-173 mos (median 42) The median survival after BMm was 3 mos (range 1-29) with 6 pts surviving more than 1 year. These long-term survivors had brain metastases in 5 cases and meningeal metastases in 1 case and were managed with surgery in 3 cases, radiotherapy in 2 cases and DOC in 1 case. Conclusions: It appears from our data that in the DOC era 1) the incidence of BMm in CRPC pts is higher than in the historical reports; 2) the interval from PC diagnosis and the appearance of BMm is clearly longer (42 mos) compared to that reported in historical series (28 mos). These findings could be related to the changes in survival of CRPC, produced by DOC introduction in the clinical practice. A special attention should be reserved to the appearance of neurological symptoms in a long-term CRPC survivor due to a possible relation with BMm. No significant financial relationships to disclose.

scholarly journals Metachronous Anal Canal and Prostate Cancers with Simultaneous Definitive Therapy: A Case Report and Review of the Literature

2011 ◽  
Vol 2011 ◽  
pp. 1-4 ◽  
Author(s):  
Edward F. Miles ◽  
Laura L. Jacimore ◽  
John W. Nelson
Keyword(s):  
Prostate Cancer ◽  
Anal Canal ◽  
Treatment Guidelines ◽  
Anal Canal Cancer ◽  
Review Of The Literature ◽  
Pelvic Radiotherapy ◽  
Course Of Action ◽  
Definitive Therapy ◽  
Risk Prostate Cancer ◽  
Prostate Cancers

Anal canal cancer is rare, accounting for only 1.3% of all gastrointestinal tract malignancies. Prostate cancer incidence is much higher and accounts for 27.6% of all malignancies in men. Treatment guidelines for anal cancer involve radiotherapy to the primary site and draining lymphatics while treatment for prostate cancer can also include pelvic radiotherapy. The literature is silent on the optimum course of action when these two malignancies are found synchronously or metachronously. Herein, we report a case of a patient diagnosed with intermediate risk prostate cancer who, prior to definitive therapy for this first malignancy, was also diagnosed with anal canal cancer. We conclude that a simultaneous approach with radiation therapy and chemotherapy with subsequent boost to the prostate is recommended. Screening for synchronous prostate cancer in male anal canal cancer patients is probably indicated and may preclude suboptimal treatment for a second occult primary.

Prevalence and Characteristics of Liver Cancer Patients in Immanuel Hospital Bandung within January 2013 until December 2014 Period

2016 ◽  
Vol 1 (4) ◽  
Author(s):  
Achmad R. Permadi ◽  
Hana Ratnawati ◽  
Teresa L. Wargasetia
Keyword(s):  
Liver Cancer ◽  
Cancer Patients ◽  
Medical Records ◽  
Clinical Symptoms ◽  
Data Retrieval ◽  
Common Cancer ◽  
Key Words Liver Cancer ◽  
Liver Cancer Patient ◽  
Right Lobe ◽  
The Right

Liver cancer is the fifth most common cancer in Indonesia. This research is to find out the prevalence and characteristics of liver cancer patients in Immanuel Hospital Bandung within the January 2013 until December 2014 period based on age, gender, clinical symptoms and predilections. This study was a descriptive verificative research with data retrieval of patients medical records that have been diagnosed with liver cancer that were hospitalized in Immanuel Hospital Bandung within January 2013 until December 2014 period. The study showed that the liver cancer patient prevalence in Immanuel Hospital Bandung within the period of January 2013 until December 2014 was 46 people. Characteristics of liver cancer patients in Immanuel Hospital Bandung within January 2013 until December 2014 period showed that the most liver cancer patients were male, compare with female with ratio 4:1, the most common age group of 56-65 years old, the most common clinical symptoms were abdominal pain with or without reffered pain to the right scapular bone and the most common predilection was right lobe of the liver. Key words: liver cancer, patients' characteristics, prevalence 

Gamma Knife surgery for multiple brain metastases from a malignant schwannoma of the penis

2006 ◽  
Vol 105 (Supplement) ◽  
pp. 238-240 ◽  
Author(s):  
Albertus T. C. J. van Eck ◽  
Gerhard A. Horstmann
Keyword(s):  
Brain Metastasis ◽  
Brain Metastases ◽  
Gamma Knife ◽  
De Novo ◽  
Tumor Resection ◽  
Gamma Knife Surgery ◽  
Malignant Schwannoma ◽  
Efficacy And Safety ◽  
Single Brain Metastasis ◽  
Therapy Option

✓The occurrence of brain metastases from a malignant schwannoma of the penis is extremely rare. In patients with a single brain metastasis, microsurgical extirpation is the treatment of choice and verifies the diagnosis. In cases of multiple or recurrent metastases, radiosurgery is an effective and safe therapy option. Gamma Knife surgery was performed in a patient who had previously undergone tumor resection and who presented with recurrence of the lesion and three de novo brain metastases. This first report on brain metastasis from a malignant penile schwannoma illustrates the efficacy and safety of radiosurgical treatment for these tumors.

Sign in / Sign up

Export Citation Format

Share Document