Prostatic cancer presenting as metastatic adenocarcinoma of sphenoid sinus

Prostatic cancer is commonly manifested by obstructive uropathy, regional lymphatic metastases, and hematogenous metastases to the axial skeleton. It is relatively rare that initial signs begin with the involvement of other sites. Intracranial metastases especially are seldom found and may be unfamiliar to not only pathologists but also to physicians. In this article, we present a case where the metastasis was first manifest as a sphenoid sinus tumor prior to the demonstration of the primary site and the prostate was confirmed to be primary by biopsy specimen with immunoperoxidase method. In addition to discussing the route of the tumor spread, we deal with a prostatic specific antigen efficient for identifying the primary site.