Metastatic Adenocarcinoma of the Prostate Presenting as Supraclavicular and Bulky Generalized Lymphadenopathy with a Benign Digital Rectal Exam

Edward J Park; Florian A Stroie; Brian J McArdle; Sarah P Psutka

doi:10.1016/j.eucr.2017.04.005

Metastatic Adenocarcinoma of the Prostate Presenting as Supraclavicular and Bulky Generalized Lymphadenopathy with a Benign Digital Rectal Exam

Urol Case Rep. 2017 May 13:13:128-130. doi: 10.1016/j.eucr.2017.04.005. eCollection 2017 Jul.

Authors

Edward J Park¹, Florian A Stroie², Brian J McArdle¹, Sarah P Psutka¹

Affiliations

¹ Cook County Health and Hospitals System, Department of Surgery, Division of Urology, 1900 W. Polk St. Ste 465 Chicago, IL 60612, USA.
² Midwestern University, Chicago College of Osteopathic Medicine, 1900 W. Polk St. Ste 465 Chicago, IL 60612, USA.

Abstract

A 63-year-old male presented with complaints of an enlarging left supraclavicular mass and weight loss. Computed tomography demonstrated a large retroperitoneal mass causing displacement of the adjacent organs, and moderate left hydroureteronephrosis. Multiple pulmonary nodules, lytic spinal lesions, and generalized lymphadenopathy including the left supraclavicular region were seen. Serum prostate-specific antigen level was 2064.0 ng/mL. Digital rectal exam revealed an enlarged prostate without nodularity. Biopsy of the supraclavicular node demonstrated prostatic adenocarcinoma. The diagnosis of lymphoma may be initially suggested, however, prostatic origin should be considered even when the prostate exam is not grossly abnormal.

Keywords: ADT, androgen deprivation therapy; BMP, basic metabolic panel; BUN, blood urea nitrogen; Benign digital rectal exam; CT, computed tomography; CaP, cancer of the prostate; DRE, digital rectal exam; DVT, deep venous thrombosis; Generalized lymphadenopathy; Metastatic prostate cancer; PSA, prostate-specific antigen; Supraclavicular lymphadenopathy; Virchow's node; Widespread lymphadenopathy.

Publication types

Case Reports