Abstract

Prostate carcinoma is one of the most common malignancies in men,¹and spreads most frequently to bone, lung, and liver.² Pleural involvement is rare. Pleural effusion as determined by autopsy ranged from 2.3 to 5%.^3,4

We describe two elderly male patients with adenocarcinoma of the prostate and secondary pleural effusion. Our first patient, a 72-year-old man, received 40 pelvic radiotherapy sessions and began treatment with bicalutamide and triptorelin. He presented with dyspnea and oppressive pain on the right side of the chest. No cough, fever or other respiratory symptoms were present. He had no symptoms of heart failure. Physical examination revealed reduced breath sounds in the right lung. Blood analysis showed elevation of prostatic specific antigen (205.12 ng/mL). Chest radiography revealed right pleural effusion. Thoracocentesis produced bloody pleural liquid with elevated proteins, lactate dehydrogenase (LDH) and an elevated prostate-specific antigen (PSA) of 429.77 ng/mL but no malignant cells. Pleural biopsy revealed malignant cells, acid phosphatase positive. The final diagnosis was pleural metastases with secondary effusion due to prostate adenocarcinoma.