Background
According to American cancer society estimates for 2022, there will about 268,490 new cases of prostate cancer and about 34,500 prostate cancer related deaths in the United states1. Patients can have variable symptoms on presentation, including anemia, paralysis from metastasis to the spinal cord, bone pain, and kidney failure from ureteral obstruction. Prostate-specific antigen (P.S.A.) and transrectal ultrasound-guided biopsy remain the best diagnostic tools, although the use of P.S.A. level for screening remains controversial.3,4 About 12% of all prostate cancer has already spread to regional lymph nodes at the time of diagnosis, with 5% of cases having distant metastases. The 5-year survival rate is only 29.8% in distant metastatic disease.1 Skeletal, lung, and liver metastases are the classic site of tumor spread, with other sites being quite rare. Our case is unique, as it presented as a posterior mediastinal metastatic mass.