Prostate Cancer With Orbital Metastasis

Area of Science:

• Oncology
• Ophthalmology
• Urology

Background:

• Prostate cancer (PCa) is a common malignancy in men, typically metastasizing to bone, lymph nodes, liver, and thorax.
• Orbital metastasis from PCa is exceptionally rare but associated with poor prognosis and potential visual impairment.

Observation:

• A 71-year-old male presented with diplopia and ptosis, revealing an intraconal orbital mass with intracranial extension.
• Diagnosis confirmed metastatic prostate adenocarcinoma with extensive bone metastases and retroperitoneal lymphadenopathy.

Findings:

• The patient received androgen deprivation therapy, docetaxel, and darolutamide for high tumor burden, castration-naïve metastatic PCa, achieving initial PSA reduction.
• Treatment was complicated by side effects, necessitating chemotherapy discontinuation; surgical resection and palliative radiation managed the orbital mass.

Implications:

• This case highlights the importance of including PCa in the differential diagnosis of orbital tumors, even in rare presentations.
• It underscores the clinical challenges and need for a multidisciplinary approach in managing atypical metastatic prostate cancer spread.