Key pathways implicated in PCa development include the following: the AR pathway, governing cell growth, survival, and differentiation [23]; the PI3K pathway, frequently activated by mutations in PTEN or PIK3CA, promoting cell proliferation and survival [23]; the MAPK/ERK pathway, often dysregulated through alterations in RAF or RAS genes, driving PCa progression; the Wnt/β-catenin pathway, activated abnormally in PCa initiation and metastasis; and the TP53 pathway, where mutations in the TP53 gene are associated with advanced PCa and therapy resistance [24]. Here, PIK3CA is linked to posterior cortical atrophy.