CASE REPORTS   

Gazzetta Medica Italiana Archivio per le Scienze Mediche 2015 October;174(10):487-9

Copyright © 2016 EDIZIONI MINERVA MEDICA

language: English

Massive pleural effusion from prostate cancer metastasis: a rare case and review of the literature

Nikolopoulos D., Yfadopoulos D., Anastasiou N., Stouraiti K., Aggeli K.

Central Clinic of Athens, Athens, Greece

Pleura metastasis of prostate cancer although not rare; is not the usual prostate malignant tumors metastases. We describe the case of a 67-year old Caucasian male suffering from massive pleural effusion associated with prostate cancer 5 years after the first diagnosis. There was a previous history of tobacco smoking (70 p.y). The patient underwent, 5 years previously, total prostatectomy followed by LH/RH and anti-androgen blockage and external beam radiation therapy for prostate cancer. On admission, the patient presented with respiratory symptoms (dyspnea) due to a massive both side pleural effusions. Pleural metastases were detected by thorax imaging studies, and biopsy samples revealed prostate adenocarcinoma as the origin of his pleural effusion. Prostate specific antigen (PSA) levels were observed to be elevated on admission. Pleural fluid was drained and talc pleurodesis was performed. The purpose of this report is to remind physicians of this rare metastatic occurrence; and to highlight the role of pleural biopsy with immunohistochemical studies to characterize this diagnosis, as pleural fluid cytology can be negative repeatedly even though pleural surface has multiple metastatic nodules.