spread
Last reviewed 01/2018
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