{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T16:35:11Z","timestamp":1787070911338,"version":"build-2736575974"},"reference-count":28,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"3","license":[{"start":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T00:00:00Z","timestamp":1720569600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-sa\/4.0"}],"content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,7]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>Prostate cancer is the second most common cancer, following lung cancer, and the fifth leading cause of cancer death in men worldwide. The onset of the disease, characterized by symptoms or changes caused by distant metastases, is rare and poses a challenge for clinicians and pathologists. We aimed to present a series of prostate carcinoma (PC) with unusual, histologically confirmed distant metastases (pM1) at the time of diagnosis, which raised suspicions of other types or origins of the primary tumor.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>Patients diagnosed with PC and distant metastases within a five-year timeframe (2017\u20132022) were extracted from the hospital database. The following data were collected: patient\u2019s age, imaging data, serum PSA level, and histopathological evaluation results. Patients with unusual distant metastases were selected and analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>We identified 10 patients in whom the diagnosis of PC was established following histopathological examination of tissue taken from distant metastatic sites (pM1). In three patients, the location of distant metastases was unusual: retroperitoneal, cranial\/dural\/epicranial and supradiaphragmatic lymph nodes which posed diagnostic challenges. Establishing the prostate origin of the tumor relied on immunohistochemical (IHC) investigation guided by clinical-imaging information.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions:<\/jats:title>\n                    <jats:p>A metastasis of PC may rarely present as a cranial\/dural tumor, retroperitoneal, or supradiaphragmatic lymphadenopathies in a man over the age of 50, but it should be taken into consideration. In the absence of correlated clinical, imaging, and histopathological\/IHC data, diagnosing distant metastasis from PC is difficult, especially considering its potentially confusing IHC profile.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.4103\/ijpm.ijpm_82_24","type":"journal-article","created":{"date-parts":[[2024,7,12]],"date-time":"2024-07-12T09:00:18Z","timestamp":1720774818000},"page":"526-532","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Metastatic onset of prostate carcinoma: A clinical and pathological challenge"],"prefix":"10.4103","volume":"68","author":[{"given":"Vlad S. F.","family":"Dema","sequence":"first","affiliation":[{"name":"Department of Urology, \u201cPius Brinzeu\u201d Emergency County Hospital, Timisoara, Romania"},{"name":"Discipline of Urology, Department XV, University of Medicine and Pharmacy \u201cVictor Babes\u201d, Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bianca R.","family":"Nataras","sequence":"additional","affiliation":[{"name":"Discipline of Morphopathology, Department of Microscopic Morphology, ANAPATMOL Research Centre, University of Medicine and Pharmacy \u201cVictor Babes\u201d, Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sorin A.","family":"Dema","sequence":"additional","affiliation":[{"name":"Department of Oncology, University of Medicine and Pharmacy \u201cVictor Babes\u201d, Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madalina","family":"Bercea","sequence":"additional","affiliation":[{"name":"Resident Laboratory, Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Barna","sequence":"additional","affiliation":[{"name":"Discipline of Morphopathology, Department of Microscopic Morphology, ANAPATMOL Research Centre, University of Medicine and Pharmacy \u201cVictor Babes\u201d, Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alin Adrian","family":"Cumpanas","sequence":"additional","affiliation":[{"name":"Department of Urology, \u201cPius Brinzeu\u201d Emergency County Hospital, Timisoara, Romania"},{"name":"Discipline of Urology, Department XV, University of Medicine and Pharmacy \u201cVictor Babes\u201d, Timisoara, Romania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","published-online":{"date-parts":[[2024,7,10]]},"reference":[{"key":"R1-20251031","first-page":"209","article-title":"Global Cancer statistics. 2020: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"71","author":"Sung","year":"2021","journal-title":"CA Cancer J Clin"},{"key":"R2-20251031","doi-asserted-by":"crossref","first-page":"3062","DOI":"10.1002\/cncr.26392","article-title":"Prostate cancer in the elderly","volume":"118","author":"Scosyrev","year":"2011","journal-title":"Cancer"},{"key":"R3-20251031","doi-asserted-by":"crossref","first-page":"367","DOI":"10.2214\/AJR.11.7533","article-title":"Atypical metastases from prostate cancer: 10-year experience at a single institution","volume":"199","author":"Vinjamoori","year":"2012","journal-title":"Am J Roentgenol"},{"key":"R4-20251031","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1002\/pros.22742","article-title":"Distribution of metastatic sites in patients with prostate cancer: A population-based analysis","volume":"74","author":"Gandaglia","year":"2013","journal-title":"Prostate"},{"key":"R5-20251031","doi-asserted-by":"crossref","first-page":"328","DOI":"10.1016\/j.annepidem.2018.03.001","article-title":"Stage-specific incidence rates and trends of prostate cancer by age, race, and ethnicity, United States, 2004-2014","volume":"28","author":"Li","year":"2018","journal-title":"Ann Epidemiol"},{"key":"R6-20251031","doi-asserted-by":"crossref","first-page":"1014","DOI":"10.1016\/j.euf.2018.04.016","article-title":"Changing incidence of metastatic prostate cancer by race and age, 1988\u20132015","volume":"5","author":"Dall'Era","year":"2019","journal-title":"Eur Urol Focus"},{"key":"R7-20251031","doi-asserted-by":"crossref","first-page":"120","DOI":"10.7326\/0003-4819-157-2-201207170-00459","article-title":"Screening for prostate cancer: U. 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