A case of metastatic prostate cancer and immune thrombocytopenia.

D M Betsch,S E Zed,S Gray

doi:10.3747/co.24.3592

D M Betsch, S E Zed + Show 1 more

Open Access

https://doi.org/10.3747/co.24.3592

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Abstract

Prostate cancer frequently metastasizes to bone, but bone marrow involvement is relatively less common. In advanced prostate cancer, significant bone marrow infiltration can result in hematologic abnormalities such as anemia and thrombocytopenia. We report the case of a patient who presented with a new diagnosis of thrombocytopenia at the same time that he presented with prostate cancer metastatic to bone. He was found to have immune thrombocytopenia (itp) which responded to treatment with steroids. We discuss this case and review the literature on itp in the setting of advanced malignancy.

Highlights

Bone is the most common site of metastasis from prostate cancer, bone marrow involvement occurs relatively less frequently[1]
With the fully informed, voluntary, and written consent of the patient, we describe an unusual case of itp presenting with advanced metastatic prostate cancer
As in other cases of carcinoma and itp discussed in the literature, the patient presented with an isolated thrombocytopenia and responsiveness to prednisone therapy

Summary

INTRODUCTION

Bone is the most common site of metastasis from prostate cancer, bone marrow involvement occurs relatively less frequently[1]. An 85-year-old man presented to the emergency department with a year-long history of progressive right groin discomfort, fatigue, and weight loss His past medical history was significant for hypertension, a multinodular goiter, and a remote history of colon cancer. Immunostaining performed on the biopsy revealed neoplastic cells positive for prostate specific antigen (psa), supportive of a metastatic carcinoma originating from the prostate [Figure 1(D)]. A rise in the patient’s psa to 490 ng/mL warranted a change in his prostate cancer therapy The patient’s platelets have remained within normal range, and prednisone has successfully been tapered He is well, and he continues on his current therapy for metastatic prostate cancer with a most recent psa of 0.55 ng/mL (Figure 3)

DISCUSSION

SUMMARY