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Leptomeningeal Metastatic Prostate Cancer Imitating a Subdural Hematoma

Metastases to the dura and adjacent parenchyma occur in 1%-2% of patients with prostate cancer. Dural metastases manifest as subdural fluid collections and present as a chronic subdural hematoma. We present a patient with advanced prostate cancer who experienced a fall and a traumatic brain injury....

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Autores principales: Zamanifekri, Behrouz, Zamanifekri, Mani, Babakoohi, Shahab, Whalen, Mark, Minagar, Alireza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Cureus 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9744416/
https://www.ncbi.nlm.nih.gov/pubmed/36523726
http://dx.doi.org/10.7759/cureus.31380
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author Zamanifekri, Behrouz
Zamanifekri, Mani
Babakoohi, Shahab
Whalen, Mark
Minagar, Alireza
author_facet Zamanifekri, Behrouz
Zamanifekri, Mani
Babakoohi, Shahab
Whalen, Mark
Minagar, Alireza
author_sort Zamanifekri, Behrouz
collection PubMed
description Metastases to the dura and adjacent parenchyma occur in 1%-2% of patients with prostate cancer. Dural metastases manifest as subdural fluid collections and present as a chronic subdural hematoma. We present a patient with advanced prostate cancer who experienced a fall and a traumatic brain injury. Computer tomography (CT) of the brain revealed a bilateral subdural hematoma (SDH). During the follow-up examination, the patient’s mental status declined, and a follow-up brain CT showed an expansion of the SDH. Brain MRI with contrast demonstrated dural lesions suspicious for metastasis to the dura. Histopathologic examination of the lesions confirmed metastatic prostate adenocarcinoma. While uncommon, leptomeningeal-dural metastatic lesions stemming from prostate adenocarcinoma should be suspected in patients with known prostate cancer who present with subdural collections. This is even more significant if the patient with prostatic adenocarcinoma has sustained a recent head injury and presents with a subdural hematoma on neuroimaging. Brain MRI provides more data towards the differential diagnosis of these lesions and should be an essential part of the diagnostic workup. Biopsy and histopathologic examination of these lesions are indicated in the diagnostic workup of these uncommon lesions.
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spelling pubmed-97444162022-12-14 Leptomeningeal Metastatic Prostate Cancer Imitating a Subdural Hematoma Zamanifekri, Behrouz Zamanifekri, Mani Babakoohi, Shahab Whalen, Mark Minagar, Alireza Cureus Neurology Metastases to the dura and adjacent parenchyma occur in 1%-2% of patients with prostate cancer. Dural metastases manifest as subdural fluid collections and present as a chronic subdural hematoma. We present a patient with advanced prostate cancer who experienced a fall and a traumatic brain injury. Computer tomography (CT) of the brain revealed a bilateral subdural hematoma (SDH). During the follow-up examination, the patient’s mental status declined, and a follow-up brain CT showed an expansion of the SDH. Brain MRI with contrast demonstrated dural lesions suspicious for metastasis to the dura. Histopathologic examination of the lesions confirmed metastatic prostate adenocarcinoma. While uncommon, leptomeningeal-dural metastatic lesions stemming from prostate adenocarcinoma should be suspected in patients with known prostate cancer who present with subdural collections. This is even more significant if the patient with prostatic adenocarcinoma has sustained a recent head injury and presents with a subdural hematoma on neuroimaging. Brain MRI provides more data towards the differential diagnosis of these lesions and should be an essential part of the diagnostic workup. Biopsy and histopathologic examination of these lesions are indicated in the diagnostic workup of these uncommon lesions. Cureus 2022-11-11 /pmc/articles/PMC9744416/ /pubmed/36523726 http://dx.doi.org/10.7759/cureus.31380 Text en Copyright © 2022, Zamanifekri et al. https://creativecommons.org/licenses/by/3.0/This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Neurology
Zamanifekri, Behrouz
Zamanifekri, Mani
Babakoohi, Shahab
Whalen, Mark
Minagar, Alireza
Leptomeningeal Metastatic Prostate Cancer Imitating a Subdural Hematoma
title Leptomeningeal Metastatic Prostate Cancer Imitating a Subdural Hematoma
title_full Leptomeningeal Metastatic Prostate Cancer Imitating a Subdural Hematoma
title_fullStr Leptomeningeal Metastatic Prostate Cancer Imitating a Subdural Hematoma
title_full_unstemmed Leptomeningeal Metastatic Prostate Cancer Imitating a Subdural Hematoma
title_short Leptomeningeal Metastatic Prostate Cancer Imitating a Subdural Hematoma
title_sort leptomeningeal metastatic prostate cancer imitating a subdural hematoma
topic Neurology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9744416/
https://www.ncbi.nlm.nih.gov/pubmed/36523726
http://dx.doi.org/10.7759/cureus.31380
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