Cutaneous metastasis in prostate cancer: Two cases with similar clinical findings

(1)

S1213

Ayşe Kavak1,2_, Murat Yılmaz1_, Haydar Kamil Çam3_, Volkan Tuğcu4_, Hülya Albayrak2_, Damlanur Sakız5_, Ümran Yıldırım6 1_{Dermatology Clinic,} Bakırköy Dr. Sadi Konuk Research and Training Hospital, 4_{Urology Clinic,} Bakırköy Dr. Sadi Konuk Research and Training Hospital, 5_{Pathology Clinic,} Bakırköy Dr. Sadi Konuk Research and Training Hospital, İstanbul, 2_Departments of Dermatology, 3_{Urology and} 6_{Pathology, Düzce} University, Düzce Medical School, Düzce, Turkey For correspondence: Dr. Ayşe Kavak, Dermatology Clinic, Bakırköy Dr. Sadi Konuk Research and Training Hospital, Bakırköy 34100, Istanbul, Turkey. E‑mail: ayse.kavak1@ gmail.com

Cutaneous metastasis in prostate cancer:

Two cases with similar clinical findings

ABSTRACT

Cutaneous metastasis of prostate cancer is rare. Lesions in this type of skin metastasis are usually seen as suprapubic nodules. Here, we presented two cases with skin metastases of prostate cancer characterized by grouped cutaneous and subcutaneous nodules.

KEY WORDS: Carcinoma, cutaneous metastasis, prostate, skin

INTRODUCTION

Prostate cancer is a common genitourinary malignancy. However, cutaneous metastasis of this cancer is rare compared to other solid organ malignancies. Cutaneous metastases of internal malignancies are rare ranging from 0.6% to 10%.[1,2]_{The incidence of cutaneous metastasis}

originating from prostate cancer is documented to be 0.36%.[3]_{Skin metastasis of prostate cancer}

is mostly characterized by flesh‑colored, pink, or violaceous nodules in suprapubic area and anterior aspects of the thighs.[4‑6]_{Here, we presented}

two cases with suprapubic and penile nodular cutaneous metastases of prostate cancer.

CASE REPORTS

Case 1

A 68‑year‑old male was referred to dermatology clinic with genital nodules. He was diagnosed with prostate adenocarcinoma (Gleason score of 4 + 5) 3 years ago. The prostate‑specific antigen (PSA) level was 94.8 ng/ml. Bone scintigraphy showed increased activity in the 3rd_lumbar

vertebra, right sacroiliac, and acetabular joint. There were no other metastasis by radiological i n v e s t i g a t i o n ( t h o r a c o a b d o m i n o p e l v i c computerized tomography). Total androgen blockage (leuprolide acetate and cyproterone) plus zoledronic acid were started. Later, antiandrogen agent was changed to bicalutamide instead of cyproterone. Almost 1 year later, castration‑resistant disease was developed. Consequently, docetaxel and prednisolone

chemotherapy was started. After eight courses of chemotherapy with a significant PSA response, a close follow‑up was suggested.

Recently, the patient noticed nodules in the suprapubic area. Dermatologic examination revealed violaceus, hard, asymptomatic cutaneous, and subcutaneous nodules in lower abdomen, suprapubic, and inguinal areas [Figure 1]. Two punch biopsies were performed. Histopathological examination revealed solid epithelial tumoral infiltration in the papillary and reticular dermis [Figure 2]. Tumor cells showed weak but diffuse positive staining for PSA by immunohistochemistry [Figure 3].

Chemotherapy was restarted. He received two cycles of docetaxel and prednisolone. However, the patient died after 2 months of detecting cutaneous metastasis.

Case 2

A 66‑year‑old male patient was followed up by urology department with the diagnosis of prostate carcinoma (Gleason score of 5 + 3). Clinical staging showed no metastasis. He received pelvic radiotherapy 70 Gy as a definitive treatment for localized prostate cancer. After 2 years, a PSA elevation was noticed, and maximal

hormonal treatment (goserelin acetate 10.8 mg and _{Website: www.cancerjournal.net}Access this article online

DOI: 10.4103/jcrt.JCRT_917_16

PMID: ***

Quick Response Code: This is an open access journal, and articles are distributed under the terms of the

Creative Commons Attribution‑NonCommercial‑ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non‑commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprints@medknow.com

Cite this article as: Kavak A, Yılmaz M, Çam HK, Tuğcu V, Albayrak H, Sakız D, et al. Cutaneous metastasis in prostate

cancer: Two cases with similar clinical findings. J Can Res Ther 2018;14:S1213‑6.

Correspondence

(2)

(3)

(4)

(5)

Cutaneous metastasis in prostate cancer: Two cases with similar clinical findings