Pelvic mass with local invasion, pathology proved prostate adenocarcinoma with regional lymphadenopathy (T4 N1 Mx).

Prostate cancer can spread by local invasion (typically into the bladder and seminal vesicles; urethral and rectal involvement are rare), lymphatic spread (pelvic nodes first followed by para-aortic and inguinal nodes), or by hematogenous metastases.