Left Supraclavicular Lymphadenopathy as the Only Clinical Presentation of Prostate Cancer: A Case Report

Abstract

A b s t r a c tProstate cancer usually metastasis to the regional lymph nodes and can rarely metastases to nonregional supradiaphragmatic lymph nodes. Cervical lymph node metastasis of prostate cancer is extremely rare. However, it should be considered in the differential diagnosis of cervical lymphadenopathy in male patients with adenocarcinoma of unknown primary site. In this report we present a rare case of metastatic prostate adenocarcinoma with left supraclavicular lymphadenopathy as the only clinical presentation with no other evidence of metastasis to the regional lymph nodes or bone metastasis.

Metastatic Cervical and Supraclavicular Lymphadenopathy from Prostate Mimicking Lymphoma: A Case Series

“…The symptoms of the patient resolved after androgen deprivation therapy as DOI: 10.4236/oju.2019.96011 100 Open Journal of Urology reported by previous studies [10]. On the contrary, one of the patients has cervical spine involvement and still having some symptom of parasthesia in the upper limbs and limitation of range of motion in the neck.…”

“…The patients had mild non-bothersome lower urinary tract symptoms (LUTS) which leads to initial presentations to physicians and other surgeons, suspicion of lymphoma and disseminated tuberculosis. This was noticed in the previous studies, that prostate cancer patients with cervical or supraclavicular lymphadenopathy may not present with LUTS which leads to suspicion of lymphoma or metastasis from aero-digestive tract [10]. Most of the cases reported were confirmed by immunohistochemistry of the metastatic cervical or supraclavicular nodal biopsy specimen which was positive for PSA [7] [10] [11] [12] [13] [14].…”

“…Metastasis to the cervical spine, supraclavicular lymph nodes and other non-regional lymph nodes is rarely reported [7]. It was reported that prostate cancer involved cervical lymph nodes in 0.4% of patients and the patients usually have widespread metastatic disease [10].…”

“…The initial metastasis is to the axial skeleton and pelvic lymph nodes [7]. Initial presentation with cervical or supraclavicular lymphadenopathy is rarely reported [8] [9] [10]. There are less than 50 cases reported in literature [11].…”

“…There are less than 50 cases reported in literature [11]. Patients will initially present to general practitioners, physicians, general surgeons, maxillofacial surgeons, Ear, Nose and Throat surgeons before proper evaluation and subsequent referral to urologist [10]. This is at the expense of progression of the disease because of delay in accurate diagnosis.…”