| Summary: | Introduction: Prostate cancer is one of the commonest, malignancies affecting elderly males. Prostatic basal cell carcinoma, (PBCC) accounts for less than 0.01% of all prostate cancers. Observation: A 32-year-old man presented with hematuria and lower urinary tract symptoms. Clinical examination showed hard, nodular enlarged prostate with multiple penile hard nodules. His prostate-specific antigen (PSA) level was 0.91 ng/mL. Histopathological examination of the fingerguided prostate biopsy revealed a malignancy with features of basal cell carcinoma. Further imaging studies were performed and metastases were found in both lungs, penis, pelvic lymph nodes and right ischium. Conclusion: The current case highlights PBCC as a diagnostic pitfall which presented in a young adult with a normal PSA level. Keywords: Prostate, Basal cell carcinoma, Metastasis
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