The unraveling of a rare case of prostate adenocarcinoma presenting as orbital mass.

Prostate adenocarcinoma (PC) is commonly known to have bone metastasis but its orbital metastasis is rare accounting for only 8.5% of cases. Most of the reported cases of orbital metastasis are in previously diagnosed PC cases. However, orbital metastasis as a sole manifestation of presentation is extremely rare, and to our knowledge, only three cases have been published similar to our present case. A 72-year-old male presented with diplopia and pain in the right eye for six months. On examination, right eye proptosis was noted. A computed tomography (CT) scan showed an enhancing, destructive soft tissue lesion involving the right orbit. The histopathological evaluation revealed a metastatic adenocarcinoma possibly of prostatic origin. Immunohistochemistry (IHC) confirmed the above diagnosis. We report this unique case of metastatic PC presenting with only ocular manifestation, emphasizing the crucial role played by diagnostic modalities like histopathology and IHC in unraveling such occult dilemmatic scenarios.