Diplopia as initial presenting sign of metastatic prostate cancer

The incidence of intracranial metastases of prostate cancer is as high as 3 2%. However, cranial nerve palsies as initial symptoms of metastatic prosta te cancer are uncommon with only 4 cases described in the literature. These tumors of the prostate known as occult carcinomas are usually diagnosed la te in the course of the disease and have an unfavourable prognosis. Therefo re in every middle-aged man with corresponding symptoms based on osteoblast ic or osteolytic intracranial tumors of unknown etiology, prostate cancer s hould be considered in the differential diagnosis and evaluated meticulousl y. We report on a 50-year-old man who initially complained of diplopia and VIth nerve palsy due to a mass in the clivus. Biopsy of the mass revealed m etastatic adenocarcinoma gland and androgen ablation as palliative therapy was initiated.