2017 Volume 31 Issue 5 Pages 648-652
Lung metastasis from prostate cancer often shows systemic relapse and recurrence, with multiple lung nodules and elevated serum prostate-specific antigen (PSA) levels. Isolated pulmonary metastasis without extrapulmonary recurrence or an elevated serum PSA level is rare. A 71-year-old man with a history of radical prostatectomy for prostate cancer performed at the age of 59 years old was referred to us with a nodule detected on plain chest radiograph. The nodule showed an increasing size. While the serum Pro-GRP and NSE levels were elevated to 70.0 and 29.0 pg/mL, respectively, the serum PSA level was within the normal range. On the basis of these findings, lung cancer, cT1bN0M0, stage IA, was suspected, and video-assisted partial resection of the right upper lobe was performed. Intraoperative frozen-section examination revealed the diagnosis of adenocarcinoma; therefore, a right upper lobectomy with mediastinal lymph node dissection was performed. Histopathologically, the tumor was composed of high columnar epithelium, with the tumor cells forming fused glands. Immunohistochemical staining revealed positive staining for PSA, which led to the diagnosis of the lung nodule as solitary lung metastasis from prostate cancer. Postoperative follow-up showed no recurrence until at least 2 years and 3 months after the surgery. We report a rare case of isolated solitary lung metastasis occurring 12 years after radical prostatectomy in the absence of an elevation of the serum PSA level, with a review of the literature.
