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Prostate cancer usually metastasizes to the regional lymph nodes, and distal metastases to supraclavicular lymph nodes are rarely reported, especially as an initial presentation. Limited case reports describe cervical lymphadenopathy as the initial presentation of metastatic prostate cancer, and often with widely disseminated disease. Patients with this initial presentation rarely undergo digital rectal examination or serum prostate-specific antigen (PSA) level measurement as part of their initial investigations. A high index of suspicion is necessary to make the diagnosis of prostate cancer in this clinical setting. We present a rare case of prostate carcinoma presenting with supraclavicular lymph node enlargement at the initial diagnosis. A review of the relevant literature is provided.

Polyembolokoilamania is the insertion of foreign objects into body orifices for sexual gratification. While the retrieval of these objects from the urethra and bladder is a well-known task among urologists, we present a rare case of an usual and serious injury from this practice: complete avulsion of the urethra at the penoscrotal junction. A single-stage urethroplasty was used to reconstruct the urethra with good result. The patient motivation, as well as concomitant medical or psychological conditions, should be explored in order to prevent further occurences.

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