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Metastatic prostate carcinoma
Other Resources UpToDate PubMed

Metastatic prostate carcinoma

Contributors: Michael W. Winter MD, Carla Casulo MD
Other Resources UpToDate PubMed

Synopsis

Prostate gland carcinoma that has disseminated. Metastatic prostate carcinoma is seen less frequently due to prostate-specific antigen screening, which enables early diagnosis of prostate cancer while it is still localized. Malignant cells can appear throughout the body as cancer advances, with the bones and lymph nodes more commonly affected.

In patients with bone metastasis, the axial skeleton is often involved. Common findings include bone pain, pathologic fracture, and spinal cord compression may be observed. Patients with lymph node involvement will present with regional or cervical lymphadenopathy. Masses may also be observed, especially in the neck. The skin, liver, and penis are also reported areas of involvement.

The findings of advanced prostate cancer include perineal pain, weight loss, and urinary changes such as frequency, retention, dysuria, and hematuria. Physical exam may reveal areas of induration, asymmetry, and/or prostate nodule. Risk factors include advancing age, family history, obesity, poor diet, elevated insulin levels, and vitamin E supplementation. More common in individuals of African descent.

Codes

ICD10CM:
C61 – Malignant neoplasm of prostate

SNOMEDCT:
94503003 – Secondary malignant neoplasm of prostate

Differential Diagnosis & Pitfalls

Metastatic prostate cancer may behave like other genitourinary cancers with metastasis to pelvic lymph nodes, bones, or other parts of the genitourinary system such as penis, ureters, kidneys, or bladder. Patients may have pain.

Differentials may include prostatic hypertrophy causing urinary retention, acute or chronic prostatitis, nephrolithiasis causing pain and hematuria, and medications causing urinary retention.

Best Tests

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References

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Last Updated:08/18/2016
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Metastatic prostate carcinoma
Metastatic prostate carcinoma : Alkaline phosphatase elevated, Bone pain, Hematuria, Low back pain, Dysuria
Imaging Studies image of Metastatic prostate carcinoma
Axial CT scan through the chest demonstrates widespread metastatic disease from prostate cancer with innumerable pulmonary nodules, mediastinal adenopathy, and replacement of all the bones by sclerotic metastases.
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