[Uncommon initial symptoms of metastasized carcinoma of the prostate]

Four patients, men aged 81, 65, 69 and 52 years, presented with painless lymphomas, pain in the lower back and legs, venous thrombosis in an arm, and headache, vomiting and other neurological complaints, respectively. They were found to have carcinoma of the prostate with metastases. After antiandrogen therapy the symptoms resolved; 2 men died after 2 years and 2 are still alive, 2 and 5 years later. In men with unexplained complaints, it is advisable to perform a thorough physical examination, including digital rectal examination and a prostate specific antigen determination.