Prostate cancer is the second most common cause of cancer death in men globally. The most common sites of metastasis include the bone, lymph nodes, lungs, liver, pleura, and adrenal glands. A 65-year-old Zambian man presented with neck swelling for 3 months with mild lower urinary tract symptoms. He reported that the swelling was fast growing, painless and with no history of trauma. On examination, Trosier’s sign was present. Histology report following a lymph node incision biopsy demonstrated Adenocarcinoma. Prostate specific antigen (PSA) was also positive. A follow up prostate biopsy found adenocarcinoma Gleason 8. This case highlights the need for a high index of suspicion in older, male patients presenting with unexplained neck swelling and no known history of prostatic adenocarcinoma.
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