Diffuse Dural Thickening and Contrast Enhancement

Abstract

Dural metastasis is a rare sign of advanced cancers, most often linked to breast, lung, and prostate cancers. With better survival rates in metastatic prostate cancer due to improvements in systemic treatment, unusual patterns like dural involvement are becoming more common. We present an unusual case of widespread dural metastasis from prostate adenocarcinoma that resulted in facial paralysis. A 69-year-old man with metastatic prostate cancer and extensive bone involvement came in with a headache and one-sided facial paralysis. A cranial MRI showed thickening of the dura and contrast enhancement affecting all dural surfaces. The patient received corticosteroids and palliative whole-brain radiotherapy, but he passed away from pneumonia three weeks later. This case emphasizes the need to consider dural metastasis in cancer patients who show unusual neurological symptoms. Early detection with cranial MRI is essential, and radiotherapy is an important option for palliative care. Reporting such rare cases helps improve awareness and guides clinical decisions.