{"doi":"10.1016/j.xocr.2025.100684","title":"Acute vision loss as the presenting symptom of metastatic prostate cancer: A case report and review of the literature","abstract":"Objective Primary sphenoid sinus neoplasms are rare, and metastasis to this site is even more rare. While prostate cancer is the most frequently diagnosed malignancy in men, it rarely spreads to the paranasal sinuses. We present the first case of sphenoid sinus metastasis from prostate adenocarcinoma presenting with acute visual impairment. Case Presentation A 54-year-old male presented with acute left-sided vision loss and intermittent headaches. Imaging revealed a sphenoid sinus mass with optic canal involvement. Biopsy showed a poorly differentiated adenocarcinoma with positive staining for NKX3.1, AMACR, and OSCAR, indicative of prostatic origin despite negative PSA. The patient was diagnosed with stage IVB prostate cancer, and further imaging showed widespread metastases. He was treated with triplet therapy (docetaxel, abiraterone/prednisone, leuprolide) and radiation to the sphenoid region. Discussion Among 22 previously reported cases, nearly half occurred in patients without a prior prostate cancer diagnosis, and none presented with acute vision loss. This case is notable for its abrupt cranial nerve involvement. Histopathology and early biopsy were critical to diagnosis and management. The patient initially responded to therapy with stable imaging and improved symptoms but later developed spinal metastases and entered hospice at 15 months. Conclusion Clinicians should consider metastatic disease in the evaluation of acute cranial neuropathies, even in the absence of systemic symptoms. Prompt imaging, biopsy, and multidisciplinary care are essential in guiding diagnosis and treatment.","journal":"Otolaryngology Case Reports","year":2025,"id":571898,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":0,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9562,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2025-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":383059,"name":"Jessa E. Miller","orcid":"0000-0001-9769-187X","position":1,"is_corresponding":false},{"id":816843,"name":"Haidee Chen","orcid":"0000-0003-2723-9313","position":2,"is_corresponding":false},{"id":467396,"name":"D. Alexander Cronkite","orcid":"0000-0003-3613-5233","position":3,"is_corresponding":false},{"id":477774,"name":"Janice Chung","orcid":"0000-0002-2941-0287","position":4,"is_corresponding":false},{"id":1251782,"name":"Jeffrey D. Suh","orcid":"0009-0007-8303-639X","position":5,"is_corresponding":false},{"id":435921,"name":"Isaac Yang","orcid":"0000-0002-5176-5615","position":6,"is_corresponding":false},{"id":933098,"name":"Jivianne T. Lee","orcid":"0000-0002-0711-855X","position":7,"is_corresponding":false},{"id":497849,"name":"Marilene B. Wang","orcid":"0000-0002-2799-6325","position":8,"is_corresponding":false},{"id":1428776,"name":"Daniel M. Beswick","orcid":"0000-0003-1898-0417","position":9,"is_corresponding":false},{"id":1128576,"name":"Eugene Oh","orcid":"0000-0002-6350-1422","position":0,"is_corresponding":true}],"reference_count":6,"raw_metadata":null,"created_at":"2026-07-19T02:57:19.669553Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}