Isolated peritoneal carcinomatosis in prostate cancer: from a successful hormonal management to a review of the literature

Abstract

Metastases from prostate cancer involve mainly the bone compartment. However, visceral metastases are found in up to 49% of metastatic patients, occurring mainly in late stages of the disease, and are correlated with poor outcome. Peritoneal carcinomatosis is rarely described in literature, particularly when not associated with other distant metastatic lesions. We present the management of a patient with prostate cancer progressing on androgen deprivation therapy with description of omental involvement on ⁶⁸Ga PSMA-PET. There was no ascite or other distant lesion, reflecting thus a specific tropism of the cancer in this patient who had no history of prostate surgery. Abiraterone acetate resulted in a long-lasting complete response. We also present a review focusing on this entity.

Lay abstract

We report an atypical presentation of metastases from prostate cancer in a patient previously treated with radiotherapy and androgen deprivation therapy. Resurgence occurred as peritoneal carcinomatosis that was diagnosed at an early stage with ⁶⁸Ga PSMA-PET. Abiraterone acetate resulted in long-lasting complete response in this patient. This case highlights the role of modern imaging in detecting early stages of complicating metastases, and to our knowledge is the first time a successful long-term response with abiraterone acetate has been observed in this entity.