Presentation of prostate carcinoma with cervical lymphadenopathy: report of three cases

The most common method of spreading of prostate cancer is via direct invasion to the pelvic organs or vertebral bodies. Supraclavicular lymph node metastasis is uncommon in patients with prostate cancer. Previously researchers have shown that the prognosis after such a presentation is generally poor. We herein present three patients with prostate carcinoma presenting with supraclavicular lymph node enlargement at the initial diagnosis. Abdominal computed tomography showed multiple enlarged lymph nodes in retroperitoneal space. All of our patients had hormone therapy and the prostate specific antigen (PSA) level declined. The mean follow up time was 16 months (range, 6-24 months). None of our patients experienced progression during follow up. Prostate carcinoma should always be considered in the differential diagnosis of elderly men with cervical lymphadenopathy, even in the absence of lower urinary tract symptoms. Evaluation of the PSA level and lymph node biopsy with PSA immunohistochemistry stain can lead to the final diagnosis. In addition, hormone treatment has been shown to be of benefit even in patients in the advanced stages.