Non-osteoblastic rhinosinusal and orbital metastasis due to prostate adenocarcinoma.

Context: Bone metastases from prostate adenocarcinoma usually present osteoblastic characteristics in imaging studies.

Method: Case report.

Results: A 77-year-old patient diagnosed with prostate adenocarcinoma with osteoblastic metastases in the dorsal spine and ribs, empirically treated with decongestants for symptoms associated with nasal polyposis, presented with binocular diplopia and ptosis of the right eyelid. Painful ophthalmoplegia and ipsilateral frozen orbit were observed. CT scan revealed a soft tissue density neoformation infiltrating the paranasal sinuses and extending to the skull base and extraocular muscles. Biopsy by endoscopic sinus surgery allowed for the diagnosis of metastasis.

Conclusions: Regardless of the characteristics evident in imaging studies, the onset of symptoms in other organs and systems in patients with a history of prostate adenocarcinoma should prompt the histopathological study of the lesions.