Prostate adenocarcinoma and cutaneous metastases

Prostate cancer is the second most frequently diagnosed cancer in men and the fifth leading cause of mortality worldwide. Men of African descent with prostate adenocarcinoma tend to present late with advanced, aggressive and often metastatic disease. Cutaneous metastases are extremely rare, with the incidence reported to be as low as 0.36%. We report a case of prostate adenocarcinoma with cutaneous metastases. A 69-year-old African male known to the urology unit, with metastatic adenocarcinoma of the prostate, presented with a two-week history of pale-to-purple large nodular lesions on the skin of his left hemiscrotum and smaller nodules on the penile shaft. Punch biopsies of the scrotal nodules revealed metastatic prostate adenocarcinoma. Bilateral orchidectomy and excision of the cutaneous lesions were performed. Although cutaneous metastases are rare, more so in patients with adenocarcinoma of the prostate, any skin lesions in patients with a known primary malignancy should raise a suspicion of metastasis. All physicians should therefore have a low threshold for the biopsy of any unusual skin lesion in patients with known prostate cancer. Level of evidence: 5.