Clinical Management of Prostate Cancer Metastasis to Pineal Gland: Case Report and Review of Literature

Background: Prostate cancer is the most common cancer among American men, with an incidence of approximately 233,000 cases per year. Intracranial metastases are rare and, specifically, metastasis to the pineal gland has only been reported in 2 postmortem cases in the literature.

Case Description: We present the first documented case of confirmed prostate cancer metastasis to the pineal gland in a living patient. The patient underwent an endoscopic third ventriculostomy and pineal lesion biopsy with complete resolution of his hydrocephalus and presenting symptoms. His biopsy results confirmed the prostate origin of the metastasis, and he subsequently underwent stereotactic radiosurgery for treatment of this lesion.

Conclusions: This is the first report of the clinical management of metastatic prostate cancer to the pineal region and description of the clinical outcome. Although prostate cancer is the most common cancer in American men, metastasis to the pineal has only been reported twice from autopsy examinations. Overall, pineal tumors in the geriatric population are exceedingly rare and the age and comorbidities in this patient made management quite unique.