{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T15:14:43Z","timestamp":1783437283328,"version":"3.54.6"},"reference-count":38,"publisher":"Journal of Neurosurgery Publishing Group (JNSPG)","issue":"16","license":[{"start":{"date-parts":[[2026,4,20]],"date-time":"2026-04-20T00:00:00Z","timestamp":1776643200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Neurosurg Case Lessons"],"published-print":{"date-parts":[[2026,4,20]]},"abstract":"<jats:sec>\n                    <jats:title>BACKGROUND<\/jats:title>\n                    <jats:p>Prostate cancer is a common malignancy in men and usually presents with elevated prostate-specific antigen (PSA) levels and metastases to the bones or lymph nodes. Brain metastases are rare, occurring in less than 1% of cases. Concurrent elevation of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9) is also uncommon.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>OBSERVATIONS<\/jats:title>\n                    <jats:p>A 61-year-old man presented with left hemiparesis and cognitive decline. Laboratory tests revealed elevated PSA, CEA, and CA19-9 levels. Imaging revealed a cystic frontal lobe mass, lung nodules, pelvic lymphadenopathy, and a prostatic lesion. MRI confirmed a 5-cm right frontal mass with heterogeneous enhancement and edema. A prostate biopsy revealed adenocarcinoma positive for CEA and CA19-9. Endoscopy revealed no gastrointestinal malignancies. Craniotomy and histopathological examination confirmed the diagnosis of adenocarcinoma. Immunohistochemical analysis revealed CEA positivity, partial CA19-9 positivity, strong NKX3.1 positivity, and PSA negativity. Postoperatively, the patient received androgen deprivation therapy with leuprorelin acetate and darolutamide, along with 5 cycles of docetaxel chemotherapy. At the 24-month follow-up, he remains neurologically stable without recurrence.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>LESSONS<\/jats:title>\n                    <jats:p>Brain metastases from prostate cancer with elevated CEA and CA19-9 are rare. Although these markers often indicate a poor prognosis, this patient achieved a favorable outcome with multimodal treatment.<\/jats:p>\n                    <jats:p>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/thejns.org\/doi\/10.3171\/CASE25735\">https:\/\/thejns.org\/doi\/10.3171\/CASE25735<\/jats:ext-link>\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3171\/case25735","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T14:23:05Z","timestamp":1783434185000},"source":"Crossref","is-referenced-by-count":0,"title":["Prostate cancer presenting as brain metastasis with concurrent elevation of carcinoembryonic antigen and carbohydrate antigen 19-9 levels: illustrative case"],"prefix":"10.3171","volume":"11","author":[{"given":"Sosuke","family":"Sumiyoshi","sequence":"first","affiliation":[{"name":"Department of Neurosurgery, Otsu Red Cross Hospital, Otsu, Shiga"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kosuke","family":"Fujii","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Otsu Red Cross Hospital, Otsu, Shiga"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhiro","family":"Kasashima","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Otsu Red Cross Hospital, Otsu, Shiga"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6043-5039","authenticated-orcid":true,"given":"Masashi","family":"Oda","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Shiga General Hospital, Moriyama, Shiga, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7334-984X","authenticated-orcid":true,"given":"Masaaki","family":"Saiki","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery, Otsu Red Cross Hospital, Otsu, Shiga"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1754","reference":[{"issue":"2","key":"bib1","series-title":"Cancer","first-page":"363","article-title":"Brain metastasis from prostate carcinoma: The M. 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