{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T14:12:35Z","timestamp":1771596755987,"version":"3.50.1"},"reference-count":27,"publisher":"MDPI AG","issue":"1","license":[{"start":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T00:00:00Z","timestamp":1771545600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Reports"],"abstract":"<jats:p>Background and Clinical Significance: Metastases of prostate adenocarcinoma most commonly involve the skeletal system, while orbital metastases, including those in the lacrimal gland, are extremely rare. Despite significant advances in the sensitivity of available imaging methods, their diagnosis is often delayed due to nonspecific clinical presentation and rarity of occurrence. Although exceedingly uncommon, orbital metastases have also been reported in other solid tumors, including certain gynecologic malignancies. Case presentation: A 49-year-old patient treated at our center for prostate adenocarcinoma with a Gleason score of 9, regional lymphadenopathy and bone metastases presented to the outpatient clinic with ptosis of the left eyelid, which had developed 7 days prior to examination (13 months after diagnosis of PC). Radiological diagnostics, including CT of the endocranium, revealed enlargement of the left lacrimal gland. An exploratory anterior orbitotomy was performed with an incisional biopsy of the tumor change under retrobulbar anesthesia, and histopathological analysis confirmed a metastatic tumor of the lacrimal gland originating from prostate adenocarcinoma. Despite the application of all available therapeutic measures, a fatal outcome occurred 6 months after the onset of ophthalmic symptoms. Discussion: Orbital involvement in metastatic prostate cancer remains poorly characterized due to its extreme rarity and nonspecific clinical presentation. This case emphasizes the need for a high index of suspicion for metastatic disease in patients with known advanced prostate cancer presenting with new orbital or lacrimal gland lesions, as imaging findings alone may be insufficient to distinguish metastases from primary orbital tumors. Conclusions: Metastasis of prostate adenocarcinoma to the lacrimal gland is an extremely rare clinical manifestation. Timely diagnosis and adequate radiological assessment are crucial for patient management and survival. The aims of this case report areto present a rare metastatic manifestation of prostate adenocarcinoma with orbital\/lacrimal metastasis of prostate adenocarcinoma origin, and to highlight metastatic prostate disease as a potential differential diagnosis in orbital lesions and the importance of imaging methods in their detection.<\/jats:p>","DOI":"10.3390\/reports9010067","type":"journal-article","created":{"date-parts":[[2026,2,20]],"date-time":"2026-02-20T13:08:23Z","timestamp":1771592903000},"page":"67","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Metastasis of Castration-Resistant Prostate Adenocarcinoma to the Lacrimal Gland: A Case Report"],"prefix":"10.3390","volume":"9","author":[{"ORCID":"https:\/\/orcid.org\/0009-0001-8143-5828","authenticated-orcid":false,"given":"Nikola","family":"Milic","sequence":"first","affiliation":[{"name":"U\u017eice General Hospital, 31000 U\u017eice, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-5128-9045","authenticated-orcid":false,"given":"Marija Varnicic","family":"Lojanica","sequence":"additional","affiliation":[{"name":"U\u017eice General Hospital, 31000 U\u017eice, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0000-3144-0779","authenticated-orcid":false,"given":"Milica","family":"Ivanovic","sequence":"additional","affiliation":[{"name":"Clinic of Obstetrics and Gynecology \u201cNarodni front\u201d, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Maja","family":"Matijasevic","sequence":"additional","affiliation":[{"name":"U\u017eice General Hospital, 31000 U\u017eice, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-3269-3069","authenticated-orcid":false,"given":"Stefan","family":"Ivanovic","sequence":"additional","affiliation":[{"name":"Clinic of Obstetrics and Gynecology \u201cNarodni front\u201d, Faculty of Medicine, University of Belgrade, 11000 Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2026,2,20]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"63","DOI":"10.14740\/wjon1191","article-title":"Epidemiology of Prostate Cancer","volume":"10","author":"Rawla","year":"2019","journal-title":"World J. Oncol."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"618","DOI":"10.1016\/j.eururo.2016.08.003","article-title":"EAU-ESTRO-SIOG Guidelines on Prostate Cancer. Part 1: Screening, Diagnosis, and Local Treatment with Curative Intent","volume":"71","author":"Mottet","year":"2017","journal-title":"Eur. Urol."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"241","DOI":"10.1016\/j.soncn.2011.07.002","article-title":"Prostate cancer overview","volume":"27","author":"Dunn","year":"2011","journal-title":"Semin. Oncol. Nurs."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"117","DOI":"10.1007\/978-3-319-99286-0_7","article-title":"Castration-Resistant Prostate Cancer: Mechanisms, Targets and Treatment","volume":"1096","author":"Mansinho","year":"2018","journal-title":"Adv. Exp. Med. Biol."},{"key":"ref_5","unstructured":"Taplin, M.E., and Smith, J.A. (2026, February 01). Clinical Presentation and Diagnosis of Prostate Cancer. UpToDate 2022. Available online: https:\/\/www.uptodate.com."},{"key":"ref_6","first-page":"245","article-title":"Prostate cancer\u2014Major changes in the American Joint Committee on Cancer eighth edition cancer staging manual","volume":"67","author":"Buyyounouski","year":"2017","journal-title":"CA Cancer J. Clin."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"578","DOI":"10.1053\/hp.2000.6698","article-title":"Metastatic patterns of prostate cancer: An autopsy study of 1589 patients","volume":"31","author":"Bubendorf","year":"2000","journal-title":"Hum. Pathol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"933","DOI":"10.1259\/bjr.72.862.10673942","article-title":"Features of unusual metastases from prostate cancer","volume":"72","author":"Long","year":"1999","journal-title":"Br. J. Radiol."},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"W371","DOI":"10.2214\/AJR.12.9553","article-title":"Lacrimal gland masses","volume":"201","author":"Gao","year":"2013","journal-title":"AJR Am. J. Roentgenol."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"147","DOI":"10.1016\/j.euf.2019.01.016","article-title":"Biological Evolution of Castration-Resistant Prostate Cancer","volume":"5","author":"Davies","year":"2019","journal-title":"Eur. Urol. Focus"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"1180","DOI":"10.1111\/j.1742-1241.2011.02799.x","article-title":"Characterising the castration-resistant prostate cancer population: A systematic review","volume":"65","author":"Kirby","year":"2011","journal-title":"Int. J. Clin. Pract."},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"3078","DOI":"10.1002\/1097-0142(19841215)54:12<3078::AID-CNCR2820541245>3.0.CO;2-U","article-title":"Metastatic patterns of prostatic cancer: Correlation between sites and number of organs involved","volume":"54","author":"Saitoh","year":"1984","journal-title":"Cancer"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"1403","DOI":"10.1001\/archopht.1988.01060140567024","article-title":"Orbital metastases from prostate carcinoma","volume":"106","author":"Boldt","year":"1988","journal-title":"Arch. Ophthalmol."},{"key":"ref_14","doi-asserted-by":"crossref","first-page":"392","DOI":"10.1016\/j.pjnns.2016.06.007","article-title":"Triple orbital metastases from prostate cancer","volume":"50","author":"Tun","year":"2016","journal-title":"Neurol. Neurochir. Pol."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"476","DOI":"10.1053\/j.sult.2006.09.002","article-title":"Imaging of the lacrimal gland","volume":"27","author":"Hughes","year":"2006","journal-title":"Semin. Ultrasound CT MR"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"100","DOI":"10.1055\/s-0040-1722700","article-title":"Masses of the Lacrimal Gland: Evaluation and Treatment","volume":"82","author":"Kim","year":"2021","journal-title":"J. Neurol. Surg. B Skull Base"},{"key":"ref_17","first-page":"229","article-title":"Terapija i protokoli pra\u0107enja gestacijskih trofoblastnih bolesti","volume":"46","year":"2012","journal-title":"Med. \u010cas."},{"key":"ref_18","first-page":"879538","article-title":"Gestational choriocarcinoma presenting with lacrimal gland metastasis: A first reported case","volume":"2015","author":"Ahamed","year":"2015","journal-title":"Case Rep. Obstet. Gynecol."},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"75","DOI":"10.1080\/01676830600675400","article-title":"Cystic orbital metastasis from endometrial carcinoma","volume":"26","author":"Char","year":"2007","journal-title":"Orbit"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1097\/01.iop.0000222355.09670.d7","article-title":"Orbital metastasis from ovarian carcinoma in a patient with BRCA2 mutation","volume":"22","author":"Singh","year":"2006","journal-title":"Ophthalmic Plast. Reconstr. Surg."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"120","DOI":"10.1016\/0090-8258(89)90025-5","article-title":"Retroorbital metastases in ovarian cancer","volume":"35","author":"Malviya","year":"1989","journal-title":"Gynecol. Oncol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"100689","DOI":"10.1016\/j.gore.2020.100689","article-title":"Orbital metastasis of squamous cell cervical cancer: A case report and review of literature","volume":"35","author":"Mendia","year":"2020","journal-title":"Gynecol. Oncol. Rep."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"524","DOI":"10.4103\/IJO.IJO_2771_22","article-title":"Orbital metastasis of choriocarcinoma from a testicular malignant germ cell tumor: A late unfavorable prognostic sign","volume":"3","author":"Kiratli","year":"2023","journal-title":"Indian J. Ophthalmol. Case Rep."},{"key":"ref_24","first-page":"e41591","article-title":"Metastatic Melanoma to the Orbit with Dedifferentiation","volume":"15","author":"Rana","year":"2023","journal-title":"Cureus"},{"key":"ref_25","first-page":"e72499","article-title":"Periocular Desmoplastic Melanoma with Orbital Invasion: A Case Report","volume":"16","author":"Amirthalingam","year":"2024","journal-title":"Cureus"},{"key":"ref_26","first-page":"e88333","article-title":"Unseen Aggressor: Amelanotic Melanoma with Orbital Metastasis\u2014Imaging and Pathologic Correlation","volume":"17","author":"Reza","year":"2025","journal-title":"Cureus"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"811","DOI":"10.17576\/MH.2025.2002.28","article-title":"Confronting Orbital Metastasis of Renal Cell Carcinoma\u2014Retrospective Case Series","volume":"20","author":"Haw","year":"2025","journal-title":"Med. 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