Metastatic brain lesions in prostate cancer

The brain is one of the rarest locations of prostate cancer (PC) metastasis with a frequency of less than 2 %. PC metastases in the brain are associated with an unfavorable prognosis due to severe symptoms, which, as a rule, significantly impairs the quality of life. The median survival rate of such patients ranges from 2 to 12 months after diagnosis. The prognosis of survival is determined by the variant of the histological structure of the primary tumor, timely treatment of the underlying disease, size, localization and number of metastatic foci in the brain. Due to the rarity of the condition, there are currently no major clinical studies on metastatic brain damage in prostate cancer and no treatment algorithm has been developed for this group of patients.
This article presents clinical observations of patients with prostate cancer with metastatic brain damage. The influence of the localization of metastatic foci on the prognosis of the disease was analyzed, the clinical characteristics of patients with intracranial metastases were detailed, treatment methods and survival outcomes were described.
Clinical observations of 2 patients who received combination therapy, i.e. hormonal therapy in combination with chemotherapy, surgery and radiation treatment for the area of distant metastasis in the brain. In the first clinical case, survival after detection of the disease was 16 months, after detection of metastatic brain lesion – 12 months, in the second clinical case – 13 months and 2 months, respectively. During magnetic resonance imaging (MRI) of the brain, a metastatic lesion of the right occipital lobe was detected in 1 case and the right hemisphere of the cerebellum in 2 cases of observation. In both cases, an MRI scan of the pelvis revealed a locally advanced prostate tumor. According to a comprehensive radiological examination, distant metastases were verified in patients, and metachronous brain damage occurred. The cause of death of the patients was the progression of prostate cancer in the form of metastatic brain damage.
In clinical practice, brain metastases in prostate cancer as an isolated lesion are extremely rare. A description of the clinical condition of patients and the severity of the disease is important in presenting the treatment experience for this category of patients.

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