Abstract
Pulmonary involvement from prostate cancer is a well‑known condition; however, solitary lung metastasis is rare, with its associated clinical characteristics not yet fully elucidated. The present study describes the case of a 77‑year‑old male, who had undergone radical prostatectomy at a previous hospital for primary prostatic carcinoma 14 years prior, who presented with a low‑grade fever. At the previous hospital, salvage radiation therapy was being considered, as the prostate‑specific antigen (PSA) level had gradually increased within the normal range. Computed tomography performed at the authors' institution revealed a solitary nodule with a spiculated morphology located on the upper lobe of the left lung, while positron emission tomography suggested malignancy without metastasis. Based on these findings, primary lung cancer was suspected and thoracoscopic left upper lobectomy with lymph node dissection was performed. The pathological diagnosis of the tumor was a solitary lung metastasis of prostate cancer. The post‑operative recovery was uneventful. In addition to reporting a case with normal PSA levels, the present study also performed a literature review. According to previous case reports, there are some pitfalls of prostate cancer leading to misdiagnosis as a primary lung tumor. However, it is considered that surgical resection is associated with an increased diagnostic accuracy and long‑term survival.
Highlights
Pulmonary metastasis secondary to prostate cancer has been reported in >40% of patients in an autopsy series [1]
The present study reports the 35th rare case of isolated lung metastasis from prostate cancer with normal prostate‐specific antigen (PSA) levels 14 years after radical prostatectomy
It has been demon‐ strated that the mean interval between biochemical recurrence (PSA re‐elevation >0.2 ng/ml twice following radical pros‐ tatectomy) and clinical recurrence is ~8 years, suggesting that the long‐term observation is required for patients with prostate cancer [27]
Summary
Pulmonary metastasis secondary to prostate cancer has been reported in >40% of patients in an autopsy series [1]. By. The present study reports the 35th rare case of isolated lung metastasis from prostate cancer with normal prostate‐specific antigen (PSA) levels 14 years after radical prostatectomy. The patient had a medical history of primary prostate cancer, patho‐ logical stage T2bN0 [Gleason score (GS): 3+4] organ‐confined disease He underwent radical prostatectomy at a former hospital when he was 63 years of age. The patient's recovery remained uneventful, and he was discharged on post‐operative day 9 His serum PSA levels decreased to 0.07 ng/ml. He was closely followed‐up at the Department of Urology in Kansai Medical University Hospital for 1 year and 4 months without any additional post‐operative treat‐ ment. No recurrent signs, including an elevation in PSA levels, have been detected far
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