Metastatic prostate carcinoma to the orbit as the first presentation of disease

Prostate carcinoma is a common tumor of the older adult male. It is associated with bony metastases, particularly to the axial skeleton. We present two case histories; in both cases, the patients had no prior history of prostate carcinoma. Both cases were diagnosed with CT imaging, elevated PSA, and biopsy. Additionally, they were treated with surgical resection and hormone modulation therapy. While bony metastases are frequently associated with advanced disease, they can also be a cause of presenting symptoms. The CT imaging in these two cases showed the classic hyperostotic findings of prostate cancer. Prostate cancer may cause osteoblastic lesions in contrast to other metastatic bone lesions, which cause destructive osteolytic lesions. During excisional surgery, the tumor was inspected and many stalactite-like lesions were present on the gross sample. We present these and compare them to the CT imaging.