Abstract
Prostate cancer is rarely diagnosed by the detection of lung metastases. We report a case of prostate cancer in a 59-year-old man detected based on abnormalities on chest radiograph and the serum prostate-specific antigen (PSA) level (6.76 ng/mL) on follow-up for prostatic hypertrophy. Chest computed tomography (CT) revealed multiple abnormal nodules in both lung fields. On the first prostate biopsy and transbronchial lung biopsy, neither lung nor prostate cancer was detected, and he was followed. One year after the first biopsy, chest CT revealed more nodules in both lung fields and the PSA level showed further elevation. A second prostate biopsy and transbronchial lung biopsy were performed, but no cancer was detected. He was diagnosed with moderately differentiated prostate adenocarcinoma with multiple lung metastases without any other metastatic lesion after VATS lung biopsy. Maximum androgen blockade (MAB) therapy was performed after the operation. Three months after the start of MAB therapy, his PSA level had normalized and the multiple pulmonary metastases had completely disappeared. There has been no evidence of recurrence or PSA relapse over a follow-up period of 25 months. Isolated pulmonary metastases from prostate cancer are rare, with only 46 previously described cases in the literature.
