Multiple intraparenchymal cystic brain metastases - a rare manifestation of metastatic adenocarcinoma of the prostate

Intraparenchymal brain metastases are rare manifestations of prostatic adenocarcinoma. Similarly, cystic intracranial metastases are even more unusual. We report on a patient with known stage IV adenocarcinoma of the prostate who presented with a recent onset of dizziness. Cranial magnetic resonance imaging demonstrated multiple cystic and nodular lesions throughout the brain parenchyma and cerebellum. At the time of diagnosis, the patient had normal PSA levels. The patient underwent palliative whole brain radiation and survived for 3 months after diagnosis with intracranial disease. We review the literature highlighting the incidence, treatment, and ongoing research endeavors to improve understanding of prostate cancer brain metastases.