Abstract
BACKGROUND: Prostate cancer frequently metastasizes to bone and regional lymph nodes, but atypical intrathoracic presentation can occur. CASE PRESENTATION: Three cases of atypical intrathoracic manifestations of metastatic prostate cancer highlight the need to consider prostate cancer in the differential diagnosis of intrathoracic lesions, even in the absence of typical bony metastases. One case involved pleural metastatic deposits with associated malignant effusion. A second patient experienced isolated endobronchial lesions that led to obstruction. The third patient had isolated pulmonary nodules without associated bone disease years after prostatectomy. We review prevalence, diagnosis, and management issues related to these unusual prostate cancer scenarios. CONCLUSIONS: These atypical metastatic manifestations of prostate cancer present diagnostic conundrums that may potentially delay timely diagnosis and appropriate management. A high index of suspicion, appropriate imaging, and judicious use of immunohistochemistry are paramount to ensure these atypical manifestations are identified.