{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,8,29]],"date-time":"2025-08-29T00:03:33Z","timestamp":1756425813719,"version":"3.44.0"},"reference-count":25,"publisher":"BMJ","issue":"9","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2019,9,4]]},"published-print":{"date-parts":[[2019,9]]},"abstract":"<jats:p>A 67-year-old male patient presents to the hospital complaining of severe nausea and vomiting failing oral antiemetics. He carries the history of initial diagnosis of stage III prostate cancer. He underwent radical prostatectomy followed by external beam radiation. After 5\u2009years of initial excellent control with androgen deprivation therapy (ADT), imaging study showed retroperitoneal adenopathy denoting ADT failure. His prostate-specific antigen continued to rise while on enzalutamide and then abiraterone reflecting disease progression. He maintained excellent functional capacity through 23 cycles of docetaxel however he started developing hip pain after the last cycle with imaging studies suggesting new hip metastatic disease. Following the first cycle of radium-223, the patient presented with intractable nausea and vomiting. MRI showed a high suspicion of leptomeningeal spread which was confirmed through a meningeal biopsy after lumbar puncture showed negative results. The patient had excellent symptomatic response to high-dose dexamethasone. After receiving whole-brain radiation, the patient opted to be on best supportive care and succumbed to his illness 3\u2009months later.<\/jats:p>","DOI":"10.1136\/bcr-2019-230922","type":"journal-article","created":{"date-parts":[[2019,9,16]],"date-time":"2019-09-16T21:10:24Z","timestamp":1568668224000},"page":"e230922","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Leptomeningeal involvement by prostate carcinoma an ominous head of a well-known Hydra"],"prefix":"10.1136","volume":"12","author":[{"given":"Fady","family":"Tawadros","sequence":"first","affiliation":[{"name":"Division of Oncology\/Hematology, Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sukesh","family":"Manthri","sequence":"additional","affiliation":[{"name":"Division of Oncology\/Hematology, Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maria","family":"Zayko","sequence":"additional","affiliation":[{"name":"Department of Pathology, East Tennessee State University James H Quillen College of Medicine, Johnson City, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kanishka","family":"Chakraborty","sequence":"additional","affiliation":[{"name":"Division of Oncology\/Hematology, Department of Internal Medicine, East Tennessee State University, Johnson City, Tennessee, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2019,9,16]]},"reference":[{"key":"2025082801390802000_12.9.e230922.1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21442"},{"key":"2025082801390802000_12.9.e230922.2","unstructured":"Facts PC-CS. SEER 18 2008-2014, All Races, Males by SEER Summary Stage 2000. Secondary SEER 18 2008-2014, All Races, Males by SEER Summary Stage. 2000 https:\/\/seer.cancer.gov\/statfacts\/html\/prost.html."},{"key":"2025082801390802000_12.9.e230922.3","doi-asserted-by":"publisher","DOI":"10.1002\/pros.22742"},{"key":"2025082801390802000_12.9.e230922.4","doi-asserted-by":"crossref","first-page":"491","DOI":"10.1002\/pros.23492","article-title":"The prognosis of different distant metastases pattern in prostate cancer: A population based retrospective study","volume":"78","author":"Shou","year":"2018","journal-title":"Prostate"},{"key":"2025082801390802000_12.9.e230922.5","doi-asserted-by":"publisher","DOI":"10.1016\/0090-4295(86)90005-1"},{"key":"2025082801390802000_12.9.e230922.6","doi-asserted-by":"crossref","first-page":"1567","DOI":"10.1007\/s00701-010-0682-x","article-title":"Adenocarcinoma of the prostate involving the lumbosacral plexus: MRI evidence to support direct perineural spread","volume":"152","author":"H\u00e9bert-Blouin","year":"2010","journal-title":"Acta Neurochir"},{"key":"2025082801390802000_12.9.e230922.7","doi-asserted-by":"crossref","first-page":"429","DOI":"10.1007\/s12032-012-0429-z","article-title":"Leptomeningeal metastases from genitourinary cancer: the University of Texas MD Anderson Cancer Center experience","volume":"30","author":"Yust-Katz","year":"2013","journal-title":"Med Oncol"},{"key":"2025082801390802000_12.9.e230922.8","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2007.12.4008"},{"key":"2025082801390802000_12.9.e230922.9","doi-asserted-by":"crossref","first-page":"376","DOI":"10.1111\/j.1440-1673.2008.01973.x","article-title":"Increased detections of leptomeningeal presentations in men with hormone refractory prostate cancer: an effect of improved systemic therapy?","volume":"52","author":"Lin","year":"2008","journal-title":"J Med Imaging Radiat Oncol"},{"key":"2025082801390802000_12.9.e230922.10","doi-asserted-by":"crossref","first-page":"191","DOI":"10.1007\/s11060-011-0734-y","article-title":"Central nervous system metastases from castration-resistant prostate cancer in the docetaxel era","volume":"107","author":"Caffo","year":"2012","journal-title":"J Neurooncol"},{"key":"2025082801390802000_12.9.e230922.11","doi-asserted-by":"publisher","DOI":"10.1097\/00000658-194007000-00016"},{"key":"2025082801390802000_12.9.e230922.12","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19820215)49:4<759::AID-CNCR2820490427>3.0.CO;2-7"},{"key":"2025082801390802000_12.9.e230922.13","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1159\/000499761","article-title":"A Case of Leptomeningeal Carcinomatosis from Aggressive Metastatic Prostate Cancer","volume":"12","author":"Carroll","year":"2019","journal-title":"Case Rep Oncol"},{"key":"2025082801390802000_12.9.e230922.14","doi-asserted-by":"publisher","DOI":"10.1002\/1097-0142(19940401)73:7<1892::AID-CNCR2820730720>3.0.CO;2-C"},{"key":"2025082801390802000_12.9.e230922.15","doi-asserted-by":"crossref","first-page":"806","DOI":"10.1007\/s12032-011-9906-z","article-title":"Durable remission of leptomeningeal metastases from hormone-responsive prostate cancer","volume":"29","author":"Zhang","year":"2012","journal-title":"Med Oncol"},{"key":"2025082801390802000_12.9.e230922.16","doi-asserted-by":"crossref","first-page":"143","DOI":"10.1007\/s12032-008-9096-5","article-title":"Prostate-specific antigen in the cerebrospinal fluid: a marker of local disease","volume":"26","author":"Orphanos","year":"2009","journal-title":"Med Oncol"},{"key":"2025082801390802000_12.9.e230922.17","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.16.4533"},{"key":"2025082801390802000_12.9.e230922.18","doi-asserted-by":"crossref","first-page":"1147","DOI":"10.1016\/S0140-6736(10)61389-X","article-title":"Prednisone plus cabazitaxel or mitoxantrone for metastatic castration-resistant prostate cancer progressing after docetaxel treatment: a randomised open-label trial","volume":"376","author":"de Bono","year":"2010","journal-title":"The Lancet"},{"key":"2025082801390802000_12.9.e230922.19","doi-asserted-by":"publisher","DOI":"10.1038\/sj.bjp.0705150"},{"key":"2025082801390802000_12.9.e230922.20","doi-asserted-by":"publisher","DOI":"10.1016\/S1470-2045(14)71205-7"},{"key":"2025082801390802000_12.9.e230922.21","doi-asserted-by":"crossref","first-page":"2465","DOI":"10.1056\/NEJMoa1800536","article-title":"Enzalutamide in Men with Nonmetastatic, Castration-Resistant Prostate Cancer","volume":"378","author":"Hussain","year":"2018","journal-title":"N Engl J Med"},{"key":"2025082801390802000_12.9.e230922.22","doi-asserted-by":"crossref","first-page":"1408","DOI":"10.1056\/NEJMoa1715546","article-title":"Apalutamide Treatment and Metastasis-free Survival in Prostate Cancer","volume":"378","author":"Smith","year":"2018","journal-title":"N Engl J Med"},{"key":"2025082801390802000_12.9.e230922.23","doi-asserted-by":"crossref","first-page":"1235","DOI":"10.1056\/NEJMoa1815671","article-title":"Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer","volume":"380","author":"Fizazi","year":"2019","journal-title":"N Engl J Med"},{"key":"2025082801390802000_12.9.e230922.24","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1001294"},{"key":"2025082801390802000_12.9.e230922.25","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa1213755"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2019-230922","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,28]],"date-time":"2025-08-28T08:39:16Z","timestamp":1756370356000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2019-230922"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,9]]},"references-count":25,"journal-issue":{"issue":"9","published-online":{"date-parts":[[2019,9,16]]},"published-print":{"date-parts":[[2019,9]]}},"alternative-id":["10.1136\/bcr-2019-230922"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2019-230922","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2019,9]]}}}