Sphenoid wing Metastasis from Occult Prostatic Carcinoma

Prostatic carcinoma commonly metastasizes to skeletal bone or vertebral bodies, forming osteosclerotic bone metastases, also it metastasizes to the head and neck region. This is the case of prostatic carcinoma presenting with an osteosclerotic metastasis to the sphenoid wing. A 64-year-old man complained of progressive left visual loss and exophthalmos. Computed tomography (CT) revealed a clear soft-density mass in the left sphenoid wing and fluorodeoxyglucose-positron emission tomography (FDG-PET) showed almost no uptake of FDG in this lesion. Biopsy from the sphenoid wing was obtained with the canine fossa approach. Pathological diagnosis was prostate adenocarcinoma. This case serves as a reminder that prostate carcinoma should be considered whenever osteosclerotic bone changes are observed on CT. FDGPET proved to be less sensitive than scintigraphy for the diagnosis of osteosclerotic metastasis from prostate carcinoma.