Nasir Ali, Saif Ur Rehman, Mutahir Ali, Imran Sabir, Rafay Azhar, Samina Mansoor.
Skin Metastasis from Prostate Adenocarcinoma.
J Coll Physicians Surg Pak Jan ;13(1):53-4.

A 65-year-old male presented to Shaukat Khanum Memorial Cancer Hospital, Lahore, having bilateral subcapsular orchidectomy and penile amputation (done elsewhere) and taking Androcur (cyproterone acetate 50 mg thrice daily orally). His PSA was 1.50 ng/ml. Patient also had 2 cms skin lesions over chin, right angle of mouth, left cheek, left scalp and right forearm. Clinically they were suspicious looking pedunculated lesions, which were excised and its histopathology was consistent with metastatic adenocarcinoma from prostate. Despite having extensive skin metastases his bone scan, chest x-ray and ultrasound abdomen were unremarkable. He was given palliative radiation therapy (30 Gy in 10 fractions on Co-60 teletherapy machine) to the penile stump. The disease was refractory to hormonal treatment so he was started on systemic chemotherapy comprising of Mitoxantrone and prednisolone. The dose of Mitoxantrone was 12 mg/m2 intravenous push on day one and prednisolone 5 mg orally twice daily from day one through twenty-one. The cycle was repeated at three weeks. After 2 cycles patient developed dry cough and shortness of breath. His chest x-ray revealed multiple lung lesions (metastatic in nature). So it was decided to stop chemotherapy. Patient was referred to palliative care. Ultimately, he died after four months of disease progression.

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