Progressive vision loss as the initial symptom of Prostate Cancer.

Althought it may vary between countries, since the prostate specific antigen screening era, metastasic prostate cancer at diagnosis accounts for approximately 10% of cases. Intracranial dural metastases are uncommon, but when present they may lead to an increase in intracranial pressure that can subsequently damage intracranial structures, such as the cranial nerves. Prolonged intracranial hypertension can cause optic nerve ischemia, leading to progressive and irreversible vision loss if untreated, hence the importance of anamnesis, complete physical examination, and clinical suspicion.

Primary neuroendocrine prostate cancer with adrenal gland metastasis.

Primary neuroendocrine differentiation in prostate cancer occurs infrequently and represents a therapeutic challenge at present due to the poor prognosis involved. We present the case of a patient with de novo neuroendocrine prostate cancer who later developed metastases to adrenals bilaterally which were initially managed surgically.