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

Abstract

Prostate cancer is the second most common cancer in men worldwide and the commonest cause of mortality in men. It is the commonest diagnosed cancer in African men. The earliest and common sites of metastasis are the axial skeleton and regional lymph nodes. Initial presentation of the metastatic disease with cervical or supraclavicular lymphadenopathy is rarely reported. We report 3 cases of metastatic cancer of the prostate presenting initially to physicians with huge cervical and supraclavicular lymph nodes enlargement which on biopsy revealed metastatic adenocarcinoma. On further evaluation, there were non-bothersome storage symptoms, elevated prostate specific antigen and abnormal digital rectal examination. Transrectal ultrasound (TRUS)-guided biopsy of hypoechoic nodules revealed high-grade adenocarcinoma of the prostate on histopathological examination. The cervical and supraclavicular lymphadenopathy resolved after commencement of androgen deprivation therapy. We advocate for prostate cancer screening in African men above 50 years of age presenting with cervical or supraclavicular lymphadenopthy to primary care physicians even in the absence of lower urinary tract symptoms.