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Introduction <p>Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating neurological condition caused by the JC virus in immunocompromised patients, including those with HIV/AIDS and immunotherapy. PML can also occur in advanced prostate cancer.</p> Presentation <p>We present a male patient in his 60s with a history of recurrent metastatic prostate carcinoma who was receiving leuprolide injections. He was admitted with a three-month history of altered mentation, recurrent falls, urinary incontinence, and difficulty with daily activities. His wife reported progressive cognitive decline, inability to perform daily tasks, forgetfulness, and multiple falls. During his hospital course, he was found to have brain lesions that were subsequently biopsied and tested positive for PML through histopathological analysis. His HIV status was non-reactive, and his CD4 count was within normal limits, at 567 cells per microliter.</p> Conclusion <p>To date, only one case has been reported in the literature regarding advanced prostate cancer. This case presents a biopsy-confirmed PML in an elderly prostate cancer patient who did not receive immunosuppressive therapy, presenting a challenge to healthcare professionals.</p> Graphical Abstract <p></p>

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When Cancer Treatment Takes a Surprising Turn: A Rare Case of PML in a Prostate Cancer Patient

  • 期刊论文

  • 发表日期：

    2025年12月6日

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  • Hafsa Parveen,
  • Imad Majeed,
  • Zaraq Rashid Khan,
  • Mohamad Belal Aldaas,
  • Asim Ali

摘要

Introduction

Progressive multifocal leukoencephalopathy (PML) is a fatal demyelinating neurological condition caused by the JC virus in immunocompromised patients, including those with HIV/AIDS and immunotherapy. PML can also occur in advanced prostate cancer.

Presentation

We present a male patient in his 60s with a history of recurrent metastatic prostate carcinoma who was receiving leuprolide injections. He was admitted with a three-month history of altered mentation, recurrent falls, urinary incontinence, and difficulty with daily activities. His wife reported progressive cognitive decline, inability to perform daily tasks, forgetfulness, and multiple falls. During his hospital course, he was found to have brain lesions that were subsequently biopsied and tested positive for PML through histopathological analysis. His HIV status was non-reactive, and his CD4 count was within normal limits, at 567 cells per microliter.

Conclusion

To date, only one case has been reported in the literature regarding advanced prostate cancer. This case presents a biopsy-confirmed PML in an elderly prostate cancer patient who did not receive immunosuppressive therapy, presenting a challenge to healthcare professionals.

Graphical Abstract