A rare case of omental metastasis as first and singular site of failure from localized prostate cancer

The most common sites of metastases from prostate cancer are the regional lymph nodes and bones followed by lung, liver, pleura and adrenals. We describe an unusual presentation of metastatic prostate cancer with omental metastases as the only site of disease. An otherwise well 72-year-old man was investigated for a rising prostate specific antigen (PSA) 12 months after curative-intent radiotherapy and androgen deprivation for high risk prostate cancer. CT scans showed omental caking with no evidence of bony or other metastases. Omental biopsy demonstrated adenocarcinoma of prostatic origin.