title: A surprising diagnosis: metastatic prostate cancer causing cervical lymphadenopathy.
abstract: 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.
authors: North Middlesex University Hospital, London, UK.
authors: Meher
authors: M
authors: Lad
authors: Anita
authors: A
authors: Sharma
authors: Darren K
authors: DK
authors: Patten
mesh_terms: D000230:Adenocarcinoma / Q000378:metabolism / Q000556:secondary*; D000368:Aged; D001859:Bone Neoplasms / Q000378:metabolism / Q000556:secondary*; D006801:Humans; D007610:Kallikreins / Q000378:metabolism; D008198:Lymph Nodes / Q000378:metabolism / Q000473:pathology*; D008206:Lymphatic Diseases / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D009333:Neck; D017430:Prostate-Specific Antigen / Q000378:metabolism; D011471:Prostatic Neoplasms / Q000378:metabolism / Q000473:pathology*
chemical_list: C549870:KLK3 protein, human; D007610:Kallikreins; D017430:Prostate-Specific Antigen