Given the growing list of active agents for mCRPC and the fact that patients will ultimately progress on any of the current treatments, buy Avagacestat it will become crucial that appropriate sequencing of treatment is known as at a period when the patient is still well enough to acquire the potential advantage of multiple therapies. It’s consequently needed for experts in oncology and urology to work together to ensure perfect access to both chemotherapy regimens. After several years of apparent chemoresistance, mCRPC has emerged into the chemotherapy age, originally with one line of chemotherapy,4 and now a two line approach centered on docetaxel followed closely by cabazitaxel,6 both supplying a survival benefit to a population that previously only had use of symptom palliation. Further data are required soon in the Nucleophilic aromatic substitution cabazitaxel early access scheme, that will shed more light on the clinical effects of the 2 line chemotherapeutic process. Optimal utilization of docetaxel and cabazitaxel depends on a multidisciplinary way of patient care, with perception from urology and oncology, to facilitate effective patient choice, regular treatment initiation and pro-active toxicity management. Metastatic tumors to the paranasal sinuses are rare. Help, testis, breast, lung, gastrointestinal tract, and thyroid gland are, in order of frequency, the most frequent locations of the primary tumors that give origin to these metastases. The sphenoid sinus is the most often involved, followed by the maxillary. In spite of the proven fact that a presentation of an occult prostatic carcinoma is not uncommon, the vast majority of these patients present with bonemetastasis impacting the axial Afatinib EGFR inhibitor skeleton. . Metastasis to the sphenoid sinus is definitely an exceptionally rare event with less-than 10 documented cases reported in the English literature. We provide an unusual case of prostatic adenocarcinoma presenting with an extensive sphenoid nose metastasis that, unlike the previous cases reported so far, has responded well to therapy and has achieved a long survival. 2. Case Report A 56-year old male with no past medical history of interest presented with a chief complaint of continuous right vision loss and numbness of the right side of the face. Cranial magnetic resonance imaging and computed tomography scan unveiled a 4. 5 4. 5 3 cm mass in the right greater wing of the sphenoid bone invading the anterior pole of the temporal lobe and the sphenoid sinus. A radical surgical approach was performed to get rid of the lesion. The study showed synaptophysin, chromogranin, PSA, CK7, CK20, CD56, TTF1, CA19. 9 and thyroglobulin, and suggested metastasis of an adenocarcinoma. Provided the positivity for prostatic specific antigen, a transrectal ultrasound guided biopsy was planned. The in-patient didn’t record any lower urinary tract problem or bone pain, and the serum PSA level was 4 ng/mL.