Skip to main content
PMC home page
British Journal of Cancer logoLink to British Journal of Cancer
. 1998 Jun;77(12):2386–2389. doi: 10.1038/bjc.1998.397

Prostate-specific antigen in the cerebrospinal fluid leads to diagnosis of solitary cauda equina metastasis: a unique case report and review of the literature.

B Schaller 1, A Merlo 1, E Kirsch 1, K Lehmann 1, P R Huber 1, P Lyrer 1, A J Steck 1, O Gratzl 1
PMCID: PMC2150374  PMID: 9649164

Abstract

A 79-year-old male patient presented with a subacute cauda syndrome caused by an intradural metastasis of the lumbosacral caudate fibres from an adenocarcinoma of the prostate, which had been treated 5 years earlier with external beam radiation therapy. Diagnosis could not be established by repeated magnetic resonance images (MRIs) during a 2-year period of increasingly severe radicular pain. Eventually, a small tumour mass could be visualized on the fourth MRI. Repeated normal serum prostate-specific antigen (PSA) did not hint at a prostate cancer metastasis (range 2.4-5.1 ng ml(-1)); however, PSA in the cerebrospinal fluid was found to be elevated (29.1 ng ml(-1)). Empirical radiation therapy of the caudate region did not improve radicular pain. Therefore, an exploratory surgical procedure was conducted, which confirmed the suspicion of an intradural prostate cancer metastasis. In conclusion, PSA in the cerebrospinal fluid provides a useful diagnostic tool for detecting intradural prostate cancer metastasis.

Full text

PDF
2387

Images in this article

2387Figure 1
on p.2387
2388Figure 3
on p.2388

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Chow T. S., McCutcheon I. E. The surgical treatment of metastatic spinal tumors within the intradural extramedullary compartment. J Neurosurg. 1996 Aug;85(2):225–230. doi: 10.3171/jns.1996.85.2.0225. [DOI] [PubMed] [Google Scholar]
  2. ELKIN M., MUELLER H. P. Metastases from cancer of the prostate; autopsy and roentgenological findings. Cancer. 1954 Nov;7(6):1246–1248. doi: 10.1002/1097-0142(195411)7:6<1246::aid-cncr2820070616>3.0.co;2-c. [DOI] [PubMed] [Google Scholar]
  3. Gleason D. F. Classification of prostatic carcinomas. Cancer Chemother Rep. 1966 Mar;50(3):125–128. [PubMed] [Google Scholar]
  4. Grant R., Naylor B., Greenberg H. S., Junck L. Clinical outcome in aggressively treated meningeal carcinomatosis. Arch Neurol. 1994 May;51(5):457–461. doi: 10.1001/archneur.1994.00540170033013. [DOI] [PubMed] [Google Scholar]
  5. Huber P. R., Mattarelli G., Strittmatter B., van Steenbrugge G. J., Schmid H. P., Maurer A. In vivo and in vitro complex formation of prostate specific antigen with alpha 1-anti-chymotrypsin. Prostate. 1995 Sep;27(3):166–175. doi: 10.1002/pros.2990270308. [DOI] [PubMed] [Google Scholar]
  6. Lilja H., Cockett A. T., Abrahamsson P. A. Prostate specific antigen predominantly forms a complex with alpha 1-antichymotrypsin in blood. Implications for procedures to measure prostate specific antigen in serum. Cancer. 1992 Jul 1;70(1 Suppl):230–234. doi: 10.1002/1097-0142(19920701)70:1+<230::aid-cncr2820701310>3.0.co;2-y. [DOI] [PubMed] [Google Scholar]
  7. Oishi M., Mochizuki Y., Yoshihashi H., Takasu T., Nakano E. Laboratory examinations correlated with severity of dementia. Ann Clin Lab Sci. 1996 Jul-Aug;26(4):340–345. [PubMed] [Google Scholar]
  8. Olson M. E., Chernik N. L., Posner J. B. Infiltration of the leptomeninges by systemic cancer. A clinical and pathologic study. Arch Neurol. 1974 Feb;30(2):122–137. doi: 10.1001/archneur.1974.00490320010002. [DOI] [PubMed] [Google Scholar]
  9. Oschmann P., Kaps M., Völker J., Dorndorf W. Meningeal carcinomatosis: CSF cytology, immunocytochemistry and biochemical tumor markers. Acta Neurol Scand. 1994 May;89(5):395–399. doi: 10.1111/j.1600-0404.1994.tb02653.x. [DOI] [PubMed] [Google Scholar]
  10. Siegal T., Sandbank U., Gabizon A., Siegal T., Mizrachi R., Ben-David E., Catane R. Alteration of blood-brain-CSF barrier in experimental meningeal carcinomatosis. A morphologic and adriamycin-penetration study. J Neurooncol. 1987;4(3):233–242. doi: 10.1007/BF00150615. [DOI] [PubMed] [Google Scholar]
  11. Sze G., Abramson A., Krol G., Liu D., Amster J., Zimmerman R. D., Deck M. D. Gadolinium-DTPA in the evaluation of intradural extramedullary spinal disease. AJR Am J Roentgenol. 1988 Apr;150(4):911–921. doi: 10.2214/ajr.150.4.911. [DOI] [PubMed] [Google Scholar]
  12. Sze G., Soletsky S., Bronen R., Krol G. MR imaging of the cranial meninges with emphasis on contrast enhancement and meningeal carcinomatosis. AJNR Am J Neuroradiol. 1989 Sep-Oct;10(5):965–975. [PMC free article] [PubMed] [Google Scholar]

Articles from British Journal of Cancer are provided here courtesy of Cancer Research UK

RESOURCES