Cervical lymphadenopathy as an initial presentation for metastatic prostate cancer has been rarely described.
Less than 30 cases have been published in medical literature whereby a lymph node biopsy revealed immunoreactivity for prostate-specific antigen (PSA) diagnosing metastatic prostate cancer. We present a unique scenario whereby an asymptomatic patient with previous high-risk gastric cancer presented to clinic with cervical lymphadenopathy. A hunt for a recurrence ensued to no avail and imaging of the head and neck showed no hint of a primary malignancy in those regions. A lymph node biopsy was undertaken which showed elements suggesting metastatic prostate cancer. The patient developed symptoms of urinary outflow obstruction shortly afterwards. Blood tests revealed a very high PSA and a bone scan showed widespread bony metastasis. He was started on androgen deprivation therapy with an improvement of his PSA and symptoms. A regular clinic follow-up has shown stable disease.
Written by:
Lad M, Sharma A, Patten DK. Are you the author?
North Middlesex University Hospital, London, UK.
Reference: BMJ Case Rep. 2014 Feb 11;2014. pii: bcr2013201630.
doi: 10.1136/bcr-2013-201630
PubMed Abstract
PMID: 24518391
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