UNCOMMON METASTATIC PATHWAYS: PROSTATE CARCINOMA METASTASIS TO THE SKULL.

Prostate carcinoma, a common malignancy in men, usually metastasizes to the vertebrae, ribs, and liver. However, skull metastasis is a rare occurrence, found in less than 2% of cases. This case report presents a male patient in his late 70s who initially exhibited a swelling on his forehead. Initially diagnosed as nodular hidradenoma through FNAC, further histological examination post-wide local excision revealed metastatic adenocarcinoma. Additional diagnostic testing uncovered advanced prostate carcinoma with a PSA level of 154 and metastases to the 4th and 6th ribs, D6 vertebra, and pubic bone. Following a bilateral orchidectomy, the patient received palliative care. This case highlights the unusual presentation and diagnostic challenges of skull metastases from prostate cancer. It underscores the importance of comprehensive diagnostic evaluations, including histology and PET scans, when faced with atypical clinical manifestations. The case emphasizes the need for heightened clinical suspicion and thorough investigation in elderly patients presenting with unexplained cranial swellings, even in the absence of urological symptoms.