Abstract

Back pain is a common complaint addressed by family physicians. We present an unusual case of a patient presenting with back pain whose work up revealed a new diagnosis of metastatic prostate cancer with bone metastasis. We present this case to highlight this unusual presentation to be kept in the differential diagnosis. A review of literature highlights the clinical features that make such a scenario likely. We review the current literature to discuss our current understanding of the mechanisms leading to such a presentation. Underlying risk factors of obesity, diabetes and chronic kidney disease seem to increase this risk. A high Gleason score with poorly differentiated features also increases the risk of de-novo metastatic presentation.