• Salim Jubran, Umberto Basso, Anna Milani, Elisa Erbetta, Andrea Di Marco, Chiara Pittarello, Nicolò Cavasin, Eleonora Lai, Silvia Stragliotto, Francesco Pierantoni, Ilaria Zampiva, Davide Bimbatti, and Marco Maruzzo.
• Oncology Unit 1, Istituto Oncologico Veneto, IOV - IRCCS, Padova, Italy.
• Medicine (Baltimore). 2024 Oct 11; 103 (41): e40016e40016.

RationaleMetastatic castration-resistant prostate cancer has a poor prognosis especially when harboring DNA damage repair gene mutations, nevertheless, in the case of pathogenic BRCA gene mutations, PARPi demonstrated a survival benefit and is a validated treatment. Nowadays, there is no data regarding unusual metastases after these drugs. Cutaneous metastases appear rarely in prostate cancer and were associated with a worse prognosis. Moreover, there are no consolidated data concerning skin tropism of prostate cancer cells, neither in the case of BRCA-associated cancers.Patient ConcernsHere, we report the case of a patient with a long history of BRCA1-mutated metastatic castration-resistant prostate cancer who developed a skin lesion on the scalp while on his fifth line of systemic therapy with olaparib. After a complete radical surgical excision, the pathology report showed prostate cancer localization.DiagnosesA diagnosis of skin metastasis from prostate cancer was reported.OutcomesThe patient then continued olaparib therapy; after 7 months from excision, he experienced further bone and biochemical progression but not cutaneous progression.LessonsA literature review of all reported cases of cutaneous metastasis in prostate cancer was conducted to shed light on the incidence, clinical presentation, diagnosis, treatment, and prognosis of this entity. We also reviewed published cases of skin metastasis in BRCA-associated cancers with an effort to correlate skin involvement with PARPi treatment, BRCAness status, and prognosis.Copyright © 2024 the Author(s). Published by Wolters Kluwer Health, Inc.

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