Solitary pulmonary nodule as the initial manifestation of isolated metastasis from prostate cancer without bone involvement: A case report

• Published in: International journal of surgery case reports 2022-01, Vol.90, p.106681-106681, Article 106681
• Main Authors: Kosaka, Tatsuaki, Iizuka, Shuhei, Yoneda, Tatsuaki, Otsuki, Yoshiro, Nakamura, Toru
• Format: Article
• Language: English
• Subjects: Case Report; Prostate cancer; Pulmonary metastasis; Second primary malignancy; Solitary pulmonary nodule
• ISSN: 2210-2612; 2210-2612
• DOI: 10.1016/j.ijscr.2021.106681

Isolated lung metastases from prostate cancer without any other organ involvement are rare. They are commonly in the form of diffuse or multiple lesions and rarely emerge as a solitary pulmonary nodule. A 61-year-old man who had undergone a laparoscopic-assisted radical prostatectomy for prostate cancer 16 months prior presented with a growing solitary pulmonary nodule. Positron emission tomography/computed tomography showed an abnormal uptake in the nodule without any other organ involvement. A surgical specimen by a thoracoscopic wedge resection proved a diagnosis of a metastasis from prostate cancer. He is currently alive only with worsening pulmonary metastases at 7 years after the lung surgery. A rare entity of isolated pulmonary metastases could be a sole finding of metastatic prostate cancer over the years and its initial manifestation could emerge as a solitary pulmonary nodule. It poses a diagnostic challenge because primary lung cancer is the leading differential diagnosis of solitary pulmonary nodules and is also one of the most frequent second primary malignancies in prostate cancer survivors. An aggressive surgical biopsy is essential for definitive histopathological and immunohistochemical analyses of solitary pulmonary nodules to distinguish a rare form of an isolated pulmonary relapse from a second primary lung cancer in prostate cancer survivors. •Isolated pulmonary metastasis without bone involvement from prostate cancer may rarely emerge as a solitary pulmonary nodule.•Primary lung cancer is a leading differential diagnosis of solitary pulmonary nodules in general and is also one of the most frequent second primary malignancies in prostate cancer survivors.•A surgical lung biopsy is a feasible option for a definitive histoimmunological diagnosis of solitary pulmonary nodules to distinguish a rare form of an isolated pulmonary metastasis from a second primary lung cancer in prostate cancer survivors.