Prostate cancer metastatic to the external auditory canals

A 58-year-old white man with prostate-specific antigen (PSA) level of 6 ng/mL, a Gleason score of 6 (3+3), and T2a adenocarcinoma of the prostate underwent prostatectomy. On review of the pathology, the specimen contained a Gleason score of 8 (3+5) with other high-risk features. The patient had a persistently elevated postoperative PSA level and was placed on total androgen blockade. The PSA continued to increase, and the patient developed bone-only metastatic disease. The patient was treated with palliative external-beam radiation and samarium. Six months later, he presented with bilateral hearing loss and was found to have pathologic and radiographic evidence of metastatic prostate cancer to the external auditory canals. This was an unusual late finding. The patient died shortly afterward before completing palliative treatment to the area.