Isolated Diplopia Revealing Metastatic Prostate Adenocarcinoma with Sphenoid Bone Involvement: A Case Report

Registration ID: IJNRD_326595

Published ID: IJNRD2606392

: https://doi.org/10.56975/ijnrd.v11i6.326595

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Inaganti Nithin Sai, Bhargavi D, Bhavitha D, Keerthana M, Mourya Reddy

Prostatic Neoplasms; Diplopia; Sphenoid Bone; Skull Base; Neoplasm Metastasis; Cranial Nerve Diseases; Orbital Apex Syndrome; Case Reports.

Background: Prostate adenocarcinoma commonly metastasizes to the axial skeleton, predominantly involving the spine and pelvis. Skull base metastases are rare, with sphenoid bone involvement representing an unusual site of dissemination. Such lesions may manifest with cranial neuropathies, posing significant diagnostic challenges. Case Presentation: A 51-year-old male presented with progressive blurring of vision and diplopia involving the left eye. Magnetic resonance imaging of the brain demonstrated an irregular enhancing extra-axial lesion involving the left medial sphenoid wing with extension into the cavernous sinus and orbital apex, resulting in compression of adjacent neurovascular structures. The patient underwent surgical decompression, and histopathological examination with immunohistochemistry confirmed metastatic adenocarcinoma of prostatic origin. Subsequent evaluation revealed markedly elevated serum prostate-specific antigen (PSA) levels, a primary prostatic lesion, and widespread skeletal metastases. Transrectal ultrasound-guided prostate biopsy confirmed acinar adenocarcinoma with a Gleason score of 4+3=7 (ISUP Grade Group 3). Management and Outcome: The patient underwent bilateral orchidectomy followed by six cycles of docetaxel chemotherapy and maintenance androgen receptor pathway inhibitor therapy. Follow-up demonstrated a marked biochemical response with significant decline in PSA levels, improvement in diplopia, and radiologically stable metastatic disease. Conclusion: Diplopia secondary to sphenoid bone metastasis is an exceptionally rare initial manifestation of metastatic prostate adenocarcinoma. Recognition of this atypical presentation is essential to facilitate early diagnosis, prompt multidisciplinary management, and timely initiation of systemic therapy, thereby improving clinical outcomes.

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Inaganti Nithin Sai, Bhargavi D, Bhavitha D, Keerthana M, & Mourya Reddy (June-2026). Isolated Diplopia Revealing Metastatic Prostate Adenocarcinoma with Sphenoid Bone Involvement: A Case Report. INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT, 11(6), d893-d895. https://doi.org/10.56975/ijnrd.v11i6.326595

Volume 11 Issue 6, June-2026

Pages : d893-d895

Paper Reg. ID: IJNRD_326595

Published Paper Id: IJNRD2606392

Research Area: Medical Science All

Author Type: Indian Author

Country: TIRUPATI, ANDHRA PRADESH, India

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Crossref DOI: https://doi.org/10.56975/ijnrd.v11i6.326595

Journal Name: INTERNATIONAL JOURNAL OF NOVEL RESEARCH AND DEVELOPMENT(IJNRD)

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