UNSTRUCTURED
This case report discusses a 59-year-old male who presented with a rash on his bilateral thighs and groin. The patient had a history of prostate cancer at stage IV with metastasis to the lymph nodes, lungs, and bones. The rash was tender to the touch and had been present for about 1 month, and the patient had attempted several treatments without relief. Upon examination, multiple firm, tender, erythematous nodules were evident on the bilateral upper thighs and mons pubis. A biopsy was performed, and the diagnosis of metastatic prostate adenocarcinoma was made.
Prostate cancer is the second most common malignancy overall and the second leading cause of death due to malignancy in the US male population. Although no established etiology exists, risk factors such as advanced age, ethnicity, familial history, and obesity have been documented. Prostate cancer typically remains localized, but metastasis can occur to the bones, liver, lungs, and lymph nodes.
Cutaneous metastases from prostate cancer are rare, with fewer than 1% of patients with metastatic disease presenting with these symptoms. Of those diagnosed with cutaneous metastases, the most common site is the chest, with the pelvis and face being the least common sites. The most typical presentation of cutaneous metastatic prostate cancer is violaceous nodules, but several presentations have been documented, such as erythematous plaques, ulcerative lesions, and zosteriform presentations. A high index of suspicion is necessary to rule out cutaneous metastases. Further, the prognosis is poor, and most patients survive less than 12 months following the diagnosis of cutaneous metastases from urologic cancers. Treatment options are often limited, and palliative care is given to alleviate symptoms.
In this case, the patient's cutaneous metastases were rare in both site and occurrence. Dermatologists should become familiar with this disorder's morphological appearance and knowledgeable about its poor prognosis when treating patients with this disease. This report highlights the significance of a thorough workup when suspicious skin lesions are present, which may aid in identifying any underlying urogenital malignancy.