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A Rare Presentation of Prostate Cancer: Psoas Muscle Metastasis Without Bone Involvement
Mahtab Zangui1, Aye M Thida1, Leen Khoury1
1Hematology and Medical Oncology, State University of New York Downstate Health Sciences University, Brooklyn, USA.
Cureus
|July 1, 2025
Summary
This case highlights metastatic prostate cancer presenting as a psoas muscle mass. Early recognition of rare metastatic sites like skeletal muscle is crucial for timely diagnosis and effective prostate cancer treatment.
Area of Science:
- Oncology
- Urology
- Medical Imaging
Background:
- Prostate cancer is a prevalent malignancy globally.
- Metastatic patterns of prostate cancer can be diverse and sometimes atypical.
- Early diagnosis and management are key to improving patient outcomes.
Observation:
- A unique case of metastatic prostate adenocarcinoma initially presenting as a psoas muscle mass is described.
- Computed tomography (CT) revealed a left psoas mass and lymphadenopathy, initially raising suspicion for rhabdomyosarcoma.
- Biopsy confirmed metastatic prostate adenocarcinoma, despite negative bone scan and spinal MRI for bone involvement.
Findings:
- The patient received anti-androgen therapy, abiraterone, and docetaxel, achieving a positive serologic and radiologic response.
- Radiation therapy was also considered per the PEACE-1 trial guidelines.
- This presentation emphasizes skeletal muscle as an unusual site for prostate cancer metastasis.
Implications:
- Recognizing atypical metastatic locations, such as skeletal muscle, is vital for accurate prostate cancer diagnosis.
- Understanding rare metastatic patterns can prevent diagnostic delays and improve patient management.
- Further research into the mechanisms of unusual metastatic spread in prostate cancer is warranted.
