Fever as a first presentation of castration-resistant prostate cancer: A case report.

Abstract

RATIONALE:

Cancer is a well-recognized cause of fever, which is related to cytokines produced by malignant cells. Prostate cancer presenting with fever and other inflammatory markers as a paraneoplastic syndrome rarely occurs.

PATIENTS CONCERNS AND DIAGNOSES:

We describe the case of high fever and lower-urinary tract symptoms that progressed 1 month prior to presentation. A 78-year-old man had been diagnosed with prostate cancer 8 months ago. He received androgen deprivation therapy with leuprolide acetate 22.5 mg for every 3 months. Castration-resistant prostate cancer was diagnosed due to elevated prostate specific antigen (1639 ng/mL) and cancer fever.

INTERVENTION:

The patient received docetaxel-based systemic chemotherapy 50 mg/mm2 biweekly. Naproxen 500 mg was administered twice a day.

OUTCOMES:

After one cycle of systemic chemotherapy, the patient had no major side effects, no more fever was observed, and the systemic condition improved.

CONCLUSION:

Differentiating cancer-related fever from infection-related fever is important for appropriate patient management. In this case, fever appeared as the first symptom of castration-resistant prostate cancer and was managed by naproxen and resolved with systemic chemotherapy.

• Authors: Tae Hoon Oh, Seung Chol Park
• Journal: Medicine (Medicine (Baltimore)) Vol. 101 Issue 30 Pg. e29428 (Jul 29 2022) ISSN: 1536-5964 [Electronic] United States
• PMID: 35905253 (Publication Type: Case Reports, Journal Article)
• Copyright: Copyright © 2022 the Author(s). Published by Wolters Kluwer Health, Inc.

Chemical References

• Androgen Antagonists
• Docetaxel
• Naproxen
• Prostate-Specific Antigen
• Leuprolide

Topics

• Aged
• Androgen Antagonists (therapeutic use)
• Antineoplastic Combined Chemotherapy Protocols (therapeutic use)
• Docetaxel (therapeutic use)
• Humans
• Leuprolide (therapeutic use)
• Male
• Naproxen (therapeutic use)
• Prostate-Specific Antigen
• Prostatic Neoplasms, Castration-Resistant (drug therapy, pathology)