Prostate cancer is second only to lung cancer as the leading cause of cancer related deaths in men. Although most men with prostate cancer have asymptomatic, indolent disease, central nervous system complications are rare and often occur with advanced metastatic disease.

We report the case of a 66-year-old man, 3 years after the initial diagnosis of advanced metastatic prostate cancer. Despite endocrine therapy initiated immediately after diagnosis, the patient developed back pain and heaviness of both lower limbs. He developed flaccid paraplegia in five days. The spinal CT scan performed on an emergency basis, showed a large lesion in the T5 and T6 vertebral bodies with extradural compression. A laminectomy T5T 6 T7 was performed and removal of the neoplasm. Histopathological examination confirmed that it was a spinal cord metastasis from prostate cancer.

Spinal cord compression occurs in up to 12% of prostate cancer patients and results in devastating morbidity. Combined treatment by laminectomy and radiotherapy seem to be associated with improved neurological function and longer survival.