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ID 62238
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Matsuo, Toshihiko Okayama University, Graduate School of Interdisciplinary Science and Engineering in Health Systems ORCID Kaken ID publons researchmap
Tanaka, Takehiro Pathology, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences ORCID Kaken ID publons
Nakamura, Aya Urology, Okayama Saiseikai General Hospital
Wada, Koichiro 5Urology, Okayama University Hospital ORCID researchmap
Abstract
Metastatic choroidal tumors derived from prostate cancer are rare. In this study, we report a patient who manifested a choroidal tumor as the initial presenting sign of prostate cancer and review 23 patients with choroidal metastasis of prostate cancer in the literature to answer a clinical question how the choroidal metastases would respond to hormonal therapy. A 73-year-old man presented with a choroidal tumor in the right eye. He was in good health and had no previous history except for current hemodialysis in 3 years due to chronic renal failure as a sequel to glomerulonephritis. With the diagnosis of a probable metastatic tumor, positron emission tomography was performed to disclose high-uptake sites in multiple bones, lymph nodes, and the prostate, together with multiple nodular lesions in bilateral lungs on computed tomography (CT) scan. Serum prostate-specific antigen (PSA) was elevated to 541 ng/mL, which supported prostate cancer as the primary site. He had degarelix injection, and the choroidal tumor resolved rapidly and became flat degeneration in a month. Prostate biopsy showed poorly differentiated adenocarcinoma, and he underwent surgical castration. He had no medication until 3 years later when he showed gradual increase of serum PSA up to 6.05 ng/mL and multiple bony metastases on CT scan. Bicalutamide, switched to enzalutamide and then to abiraterone, led to the undetectable level of serum PSA until the last visit with no relapse of the choroidal metastasis, 6.8 years after the initial visit. In the literature review of 24 patients with choroidal metastasis of prostate cancer, including this patient, 8 patients presented a choroidal tumor as the initial sign and the choroidal lesions mostly showed complete response to hormonal therapy. Among 13 patients who were frequently in the course of hormonal therapy, choroidal metastases showed complete or partial response to external beam radiation to the eye in 11 patients and episcleral plaque radiotherapy in 2 patients. In conclusion, metastatic choroidal tumors of prostate cancer would show good response to hormonal therapy when the therapy has not been initiated. Hormone-resistant choroidal metastases in the therapeutic course of prostate cancer could be managed successfully by external beam radiation to the eye.
Keywords
prostate cancer
choroidal/uveal tumor
choroidal/uveal metastasis
radiation
surgical castration
complete remission
hormonal therapy
literature review
prostate-specific antigen
PSA
positron emission tomography
PET
Published Date
2021-06-23
Publication Title
Journal of Investigative Medicine High Impact Case Reports
Volume
volume8
Publisher
American Federation for Medical Research
Start Page
1
End Page
8
ISSN
2324-7096
Content Type
Journal Article
language
English
OAI-PMH Set
岡山大学
Copyright Holders
© 2021 American Federation for Medical Research
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publisher
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NAID
DOI
Related Url
isVersionOf https://doi.org/10.1177/23247096211026471
License
https://creativecommons.org/licenses/by-nc/4.0/