Atypical Presentation of Prostate Cancer and the Workup of an Adenocarcinoma of Unknown Primary.

Prostate Adenocarcinoma is one of the most commonly diagnosed cancers in the United States, with a prevalence of around 2.4 million. Patients with this disease commonly present with urinary frequency and hesitancy, nocturia, and dysuria secondary to tumor enlargement. We present the case of a 60-year-old man with multiple-site biopsy proven metastatic prostate cancer that presented with neither urological or bone related signs or symptoms. His findings were rather atypical; they included dyspnea, pancytopenia, nausea, and chills. We then detail how we narrowed our diagnosis through a systemic process of elimination, and review the general workup of an adenocarcinoma of unknown primary in a male patient.