Prostate cancer is the most common cancer and the second leading cause of cancer death among American men. The most common locations of prostate cancer metastases are the axial skeleton, pelvic lymph nodes, and lungs (1). Early clinical presentation of intracranial prostate metastases without initial metastases to other sites is extremely uncommon and has been documented in a small number of case reports (2, 3). Tremont-Lukas et al reported in a study done at MD Anderson Cancer Center that brain metastases represented only 1.6% of all metastases from prostate adenocarcinoma (1). Not only are intracranial prostatic metastases rare, but involvement of the pineal gland has only been seen in 0.3% of cases (4). Within the English literature, there have been 2 postmortem cases of metastases to the pineal gland and one documented case of a living patient reported by Hogan et al in 2019. In the first documented case of a living patient with pineal gland prostate cancer metastasis, bone metastases were found 2 years prior to the pineal gland metastasis, showing a more common clinical presentation seen with prostate adenocarcinomas (5). Stereotactic radio-surgery was performed which is the standard treatment plan for patients with solitary or oligo metastatic brain lesions. This treatment modality has been in use for many years for other types of pineal gland tumors including germinomas. [Read More]
