IŞIL ÇETİN, ETKİN MARANGOZ, FAZLI YANIK
Turkish Medical Student Journal - 2025;12(2):39-43
Prostate cancer is the fourth most diagnosed cancer and the eighth leading cause of cancer-related mortality globally. Although distant metastases of prostate cancer are common, isolated pulmonary metastasis is exceptionally rare, occurring in fewer than 1% of cases. We present the case of a 61-year-old male who was diagnosed with extraprostatic highly invasive prostate adenocarcinoma in 2011, at the age of 49. He had a high prostatespecific antigen level of 41 ng/mL and a Gleason score of 7 (4+3), placing him in the intermediate-risk category (grade group 3). Following a radical prostatectomy, external iliac and pelvic lymphadenectomy, the patient was regularly monitored. Twelve years later, during routine follow-up and restaging, a Gallium-68 prostate-specific membrane antigen positron emission tomography computed tomography scan revealed a 2 cm nodular lesion in the upper lobe of the left lung, which was identified as a metastasis of prostate cancer. Histopathological analysis following surgical resection confirmed the diagnosis of isolated lung metastasis of prostate cancer. To the best of our knowledge, this is only the second reported case of singular pulmonary metastasis of prostate cancer in Türkiye. This case highlights the rarity of isolated pulmonary metastasis in prostate cancer, which occurs in fewer than 1% of cases. Despite the absence of elevated high prostate-specific antigen levels, long-term follow-up and routine imaging are essential for detecting distant metastases in prostate cancer patients. This case underscores the need for careful monitoring and imaging of prostate cancer patients during long-term follow-up, even in the absence of elevated prostate-specific antigen levels, to detect unusual metastatic sites like isolated pulmonary metastasis.
