Download PDF
CC BY 4.0 · World J Nucl Med 2024; 23(04): 302-306
DOI: 10.1055/s-0044-1788736
Case Report

Portal Venous Tumor Thrombosis and Visceral Organ Metastasis without Skeletal Involvement in mCRPC: Adverse Prognostic Indicators on Dual Tracer PET/CT and Clinical Outcome after 177Lu-PSMA-617 PRLT and Cabazitaxel Therapy

Yeshwanth Edamadaka
1   Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai, India
2   Homi Bhabha National Institute, Mumbai, India
,
Rahul V. Parghane
1   Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai, India
2   Homi Bhabha National Institute, Mumbai, India
,
Sandip Basu 
1   Radiation Medicine Centre, Bhabha Atomic Research Centre, Tata Memorial Hospital Annexe, Jerbai Wadia Road, Parel, Mumbai, India
2   Homi Bhabha National Institute, Mumbai, India
› Author Affiliations
› Further Information
Also available at
   Permissions and Reprints

Abstract

Prostate cancer involving visceral organs are occurrences in the later disease course, usually following regional nodal and skeletal involvement, and are refractory to conventional treatment. A 61-year-old male patient presented with locally advanced disease at presentation, which progressed on androgen deprivation therapy and systemic therapy with involvement of the visceral organs (lungs and liver). Portal venous tumor thrombosis involving the right and main branch was also observed on contrast-enhanced computed tomography (CECT) and magnetic resonance imaging (MRI), which showed intense uptake on 68Ga-labeled prostate-specific membrane antigen positron emission tomography/computed tomography (68Ga-PSMA-11 PET/CT) and 18F-fluorodeoxyglucose PET/CT (18F-FDG-PET/CT). Post-177Lu-PSMA-617 radioligand therapy (PRLT) showed mixed response on tumor marker and imaging analysis with survival of 6 months after 177Lu-PSMA radioligand therapy. The high Gleason score, visceral organ metastasis, and increased metabolic activity on FDG were the adverse prognostic factors in the described patient.

Keywords

prostate cancer - metastatic castration-resistant prostate cancer - liver metastasis - portal venous tumor thrombosis - 68Ga-PSMA-11 PET/CT - 18F-FDG-PET/CT - 177Lu-PSMA-617 radioligand therapy


Publication History

Article published online:
24 July 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, 2nd Floor, Sector 2, Noida-201301 UP, India

 

  • References

  • 1 Gandaglia G, Abdollah F, Schiffmann J. et al. Distribution of metastatic sites in patients with prostate cancer: a population-based analysis. Prostate 2014; 74 (02) 210-216
    CrossrefPubMedSearch in Google Scholar
  • 2 Alumkal JJ, Chowdhury S, Loriot Y. et al. Effect of visceral disease site on outcomes in patients with metastatic castration-resistant prostate cancer treated with enzalutamide in the PREVAIL Trial. Clin Genitourin Cancer 2017; 15 (05) 610-617.e3
    CrossrefPubMedSearch in Google Scholar
  • 3 Kadeerhan G, Xue B, Wu X-L, Chen W-N, Wang D-W. Incidence trends and survival of metastatic prostate cancer with bone and visceral involvement: 2010-2019 surveillance, epidemiology, and end results. Front Oncol 2023; 13: 1201753
    CrossrefPubMedSearch in Google Scholar
  • 4 Iwamoto H, Izumi K, Shimada T. et al. Androgen receptor signaling-targeted therapy and taxane chemotherapy induce visceral metastasis in castration-resistant prostate cancer. Prostate 2021; 81 (01) 72-80
    CrossrefPubMedSearch in Google Scholar
  • 5 Buxton AK, Abbasova S, Bevan CL, Leach DA. Liver microenvironment response to prostate cancer metastasis and hormonal therapy. Cancers (Basel) 2022; 14 (24) 6189
    CrossrefPubMedSearch in Google Scholar
  • 6 Vinjamoori AH, Jagannathan JP, Shinagare AB. et al. Atypical metastases from prostate cancer: 10-year experience at a single institution. AJR Am J Roentgenol 2012; 199 (02) 367-372
    CrossrefPubMedSearch in Google Scholar
  • 7 Pouessel D, Gallet B, Bibeau F. et al. Liver metastases in prostate carcinoma: clinical characteristics and outcome. BJU Int 2007; 99 (04) 807-811
    CrossrefPubMedSearch in Google Scholar
  • 8 Halabi S, Kelly WK, Ma H. et al. Meta-analysis evaluating the impact of site of metastasis on overall survival in men with castration-resistant prostate cancer. J Clin Oncol 2016; 34 (14) 1652-1659
    CrossrefPubMedSearch in Google Scholar
  • 9 Seifert R, Telli T, Hadaschik B, Fendler WP, Kuo PH, Herrmann K. Is 18F-FDG PET needed to assess 177Lu-PSMA therapy eligibility? A VISION-like, single-center analysis. J Nucl Med 2023; 64 (05) 731-737
    CrossrefPubMedSearch in Google Scholar
  • 10 Buteau JP, Martin AJ, Emmett L. et al; TheraP Trial Investigators and the Australian and New Zealand Urogenital and Prostate Cancer Trials Group. PSMA and FDG-PET as predictive and prognostic biomarkers in patients given [177Lu]Lu-PSMA-617 versus cabazitaxel for metastatic castration-resistant prostate cancer (TheraP): a biomarker analysis from a randomised, open-label, phase 2 trial. Lancet Oncol 2022; 23 (11) 1389-1397
    CrossrefPubMedSearch in Google Scholar
  • 11 Khreish F, Kochems N, Rosar F. et al. Response and outcome of liver metastases in patients with metastatic castration-resistant prostate cancer (mCRPC) undergoing 177Lu-PSMA-617 radioligand therapy. Eur J Nucl Med Mol Imaging 2021; 48 (01) 103-112
    CrossrefPubMedSearch in Google Scholar
  • 12 Sathekge MM, Lawal IO, Bal C. et al. Actinium-225-PSMA radioligand therapy of metastatic castration-resistant prostate cancer (WARMTH Act): a multicentre, retrospective study. Lancet Oncol 2024; 25 (02) 175-183
    CrossrefPubMedSearch in Google Scholar
  • 13 Feuerecker B, Tauber R, Knorr K. et al. Activity and adverse events of actinium-225-PSMA-617 in advanced metastatic castration-resistant prostate cancer after failure of lutetium-177-PSMA. Eur Urol 2021; 79 (03) 343-350
    CrossrefPubMedSearch in Google Scholar