Unusual Presentation of Metastatic Prostate Cancer: A Case Report

Abstract

61-year-old male, previously healthy, presented to Primary care with four-month history of non-tender, non-traumatic left lower neck mass. Patient denied any significant urinary or constitutional symptoms or any bone pain. A referral for neck Ultrasound was organized which showed an abnormal rounded hypoechoic left SCF (supraclavicular fossa) node with loss of fat hilum. USS (Ultrasound)-guided biopsy of this node was performed, and while histological results were being awaited, a CT (neck, chest and abdomen) was done. The scan results demonstrated multiple left SCF and upper left retroperitoneal/para-aortic nodes. A working diagnosis of Lymphoma was entertained at this point and whilst the result of the biopsy was being awaited a PET-CT was done which showed the presence of metabolically active left SCF nodes, of which, the most prominent one showing a standardized uptake value (SUVMax=4). In addition, the scan showed a focal activity in the right peripheral zone of the prostate gland (SUVMax=5) along with metabolically active lesions involving the pelvic bones and the neck of the left femur consistent with skeletal metastases (SUVMax=6). Biopsy of the left SCF node showed evidence of prostatic adenocarcinoma. This case report reviews an uncommon presentation of prostate cancer with supraclavicular adenopathy.