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Spread

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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Prostatic carcinoma spreads in three ways:

  • direct local invasion:
    • usually involves the seminal vesicles, base of the bladder, and urethra
    • rectal involvement is uncommon and late

  • lymphatic:
    • initially to the obturator nodes, followed by perivesical, hypogastric, ilial, pre-sacral and para-aortic nodes

  • haematogenous:
    • particularly to bones
    • tumour cells have ready access to the rich venous plexus contained within the fibrous sheath of the gland capsule
    • common sites for metastasis are, in descending order of frequency, lumbar spine, proximal femur, pelvis, thoracic spine, ribs and skull
    • lesions are typically osteosclerotic
    • spread may also occur to the liver and the lung

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