Prostatic cancer presenting as palpable lymph-node metastases: A case report

A 48-year-old man visited our hospital complaining of nodules in the left neck. Physical examination revealed firm, smooth and movable masses of 1 to 2 cm in diameter in the bilateral neck, and in the left supraclavicular, bilateral axillar anti bilateral inguinal regions. On digital rectal examination, a hen's egg sized, smooth and elastic firm prostate was observed. The serum prostatic acid phosphatase and prostate-specific antigen levels were elevated. Needle biopsy of the prostate showed poorly differentiated adenocarcinoma. Treatment with LH-RH agonist, diethylstilbestrol diphosphate, ifosfamide and cisplatinum was effective and the patient has responded well. The enlarged lymph nodes have since shrunk markedly, and the serum prostatic acid phosphatase and prostate-specific antigen levels have also fallen to normal levels. This case indicated the presence of an unusual prostatic cancer in which non-regional superficial lymph-node metastases occurred.