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Atypical Presentation of Prostatic Cancer with Left Axillary and Supraclavicular Lymphadenopathy

Open Journal of Urology 2022年第4期12卷 228-236页

作者： Mohamed Izeldeen Ibrahim abdulgadir elsunny hamadelnil Mutaz Mohamed Rehab Osman Abdelrhman Tamir A. Mahmmoud Ahmed M. Elnour Hala Yagoub Lyla M. Alagab Ahmed Gaper Hamad Department of Urology Prince Osman Digna Referral Hospital Portsudan Sudan Department of Surgery Red Sea University Portsudan Sudan Department of General Surgery Ministry of Health Sudan Department of Radiology Port Corporation Hospital Portsudan Sudan Sudan Medical Specialization Board Khartoum Sudan Prince Osman Digna Referral Hospital Portsudan Sudan

Introduction: The burden of prostatic cancer is rising in Sudan. Usually, they present late in their disease with urinary tract obstruction, hematuria, bony pain, or cachexia because there is no screening program. Here we present a patient with prostatic cancer who presented with left axillary mass as his main concern. Case Description: 82-year-old Sudanese male presented with a left axillary and left supraclavicular lymphadenopathy of a few months’ duration. He underwent a decisional biopsy which showed metastatic adenocarcinoma. Upper and lower GI endoscopy were performed but the latter was complicated by a sigmoid perforation with peritonitis. During laparatomy, multiple enlarged pelvic lymphnodes were encountered and a biopsy result suggested a metastatic prostatic neoplasm. Later, prostatic biopsy confirmed the diagnosis. The patient was treated with bilateral orchidectomy. Clinical discussion: Lymphatic metastasis to axillary lymph nodes is a very rare manifestation of prostate cancer and only a few cases have been reported in the literature. It can cause diagnostic difficulty since prostate cancer typically metastasis to the pelvic lymph node and very rarely involves he supradiaphragmatic lymph node. Conclusion: Metastatic prostatic carcinoma should be considered among the causes of supra-diaphragmatic lymph adenopathy. Careful physical and imaging examinations combined with PSA and pathological analysis are essential in the diagnosis of advanced prostate cancer with unusual presentation.

关键词： Prostatic Cancer Adenocarcinoma Axillary Metastasis Supraclavicular Metastasis Atypical Presentation

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