Neck mass as the first presentation of metastatic prostatic adenocarcinoma

Adenocarcinoma of the prostate (CAP) is a rare diagnosis in men younger than 50 years of age; this age group accounts for less than 0.1% of all patients with prostatic cancer. Left supraclavicular lymphadenopathy (LSCL) as the presenting symptom of metastatic CAP is even rarer. No cases of CAP presenting as LSCL in men younger than 45 years have been reported in the literature. Here we report a 42-year-old male with the uncommon presentation of CAP as LSCL. In adult males with persistent LSCL, even if younger than 45 years, measurement of serum prostate specific antigen is warranted at the time of initial presentation, and the lymph node biopsy should be subsequently stained for prostate specific antigen immunohistochemically. These examinations are crucial to establish a definitive diagnosis of CAP and, in turn, to institute appropriate management and achieve the best possible outcome.