Prostate cancer metastatic to the external auditory canals

Area of Science:

• Oncology
• Urology
• Pathology

Background:

• A 58-year-old man diagnosed with early-stage prostate cancer (Gleason 6, T2a) underwent prostatectomy.
• Postoperative pathology revealed higher-grade disease (Gleason 8) with high-risk features, indicating a more aggressive cancer.
• The patient exhibited a persistently elevated prostate-specific antigen (PSA) post-surgery, necessitating androgen deprivation therapy.

Observation:

• Despite treatment, the patient's PSA levels continued to rise, and he developed bone-only metastatic prostate cancer.
• He received palliative radiation and samarium treatment for bone metastases.
• Six months after initial treatment, the patient presented with bilateral hearing loss.

Findings:

• Radiographic and pathological examination confirmed metastatic prostate cancer in the external auditory canals.
• This represented an unusual and late-stage manifestation of the disease.
• The patient's condition rapidly declined, and he died before further palliative care could be administered.

Implications:

• This case underscores the potential for prostate cancer to metastasize to uncommon sites, even late in the disease course.
• It highlights the importance of considering atypical presentations in patients with advanced or refractory prostate cancer.
• Further research may be needed to understand the mechanisms behind such rare metastatic patterns.