Craniocerebral Metastasis of a Prostatic Adenocarcinoma Revealed by a Frontal Bump: A Case in Gabon

Abstract

Back ground: Prostate cancer is the most common urological cancer in men over fifty. Its most common metastatic sites are bone, lymph nodes, liver, and lungs. Cranial metastases are rare. The authors report a rare case of craniocerebral metastasis from prostatic adenocarcinoma revealed by a frontal bossing in Gabon. Case Presentation : A 63-year-old male electrician with no specific medical history was admitted for a painful frontal bossing that had appeared 8 months earlier. The physical examination was normal apart from the frontal mass, with no neurological signs. A digital rectal examination noted hypertrophy of the left prostatic lobe, and a PSA level of 1430 ng/ml was measured. A biopsy of the frontal mass revealed histologically a prostatic adenocarcinoma. A thoracoabdominopelvic CT scan and brain MRI showed lymph node, bone, and parietofrontal involvement, classifying the lesion as T4N1M1. Proce dure: Complete androgen blockade was performed using a combination of bicalutamide and leuprorelin. Outcomes: The initial progression under treatment was a reduction of the frontal mass and a decrease in the ASPT level. However, the patient died nine months later. Conclusion: Any cranioencephalic mass in an elderly male should raise the possibility of secondary metastasis from prostate cancer until proven otherwise.