Introduction: Weight loss and fatigue are frequent symptoms as are dysphagia and vomiting. Looking for diagnosis, one would think first about gastric or oesophageal pathology. Combined with abdominal mass, upper abdominal cancer would be a good main hypothesis. We describe here a case of prostatic cancer in a healthy patient showing no urinary symptoms. Case description: A 54-year-old man, without medical history, is admitted to the ER for weight loss, fatigue, dysphagia to solids and pre- cocious postprandial vomiting that begun a month ago. Weight loss reaches about 10kg. Clinical examination shows multiple pulseless hard abdominal masses, larger than 5cm and discrete lower limbs oedema. Peripheral pulses are present and symmetrical. Blood analysis reveals severe anemia (Hb 5.6g/dl), kidney failure (creatinine 1.7mg/dl, GFR 40ml. min-1), increase in LDH (400UI/ml) and lactate (4.4mmol/l) levels. Blood transfusion and IV-hydration restore Hb-level to 9.2g/dl but do not correct lactatemia or kidney failure. Abdominal CT (figure 1A-1B) confirms mul- tiple tumors as being retro-peritoneal lymph nodes reaching sizes up to 10cm, along with a bilateral ureterohydronephrosis due to compression. Prostate is irregular and numerous sclerotic bone metastases of the spine are showed. PSA level is 16033mg/l (nl o5). Results: A prostatic adenocarcinoma is confirmed by lymph node biopsy. Scans (figure 2A-2B) done 40 days after introduction of Degarelix (GnRH antagonist) show a major decrease in tumor volume (465%). No chemotherapy was initiated due to lack of follow-up from the patient. PSA level is then 40mg/l. Anemia stays non-regenerative due to bone marrow involvement. Clinical symptoms resolved.