Mbwambo Orgeness J, Mremi Alex, Mbwambo Jasper S, Bright Frank, Mteta Alfred K, Ngowi Bartholomeo N
Department of Urology, Kilimanjaro Christian Medical Centre, Moshi, Tanzania.
Faculty of Medicine, Kilimanjaro Christian Medical University College, Moshi, Tanzania.
J Surg Case Rep. 2020 Nov 30;2020(11):rjaa476. doi: 10.1093/jscr/rjaa476. eCollection 2020 Nov.
Prostate cancer is one of the commonest cancers among men contributing significantly to the overall cancer burden globally. Most patients present with lower urinary tract symptoms. Metastasis to supraclavicular lymph nodes is unusual presentation, which has been rarely reported particularly as the primary presentation. We report two rare cases of advanced prostatic adenocarcinoma presenting with firm, non-tender lump in the left supraclavicular region between the two heads of the sternocleidomastoid muscle, (that is Virchow's node) as initial primary symptom. Examination of the patients revealed an elevated prostatic-specific antigen (PSA) of > 100 ng/ml levels, and the diagnosis was confirmed by histological evaluation and immunostaining with PSA of the supraclavicular lymph nodes and prostate biopsies. This case series emphasizes the importance of considering prostate cancer in the differential diagnosis of male patients with supraclavicular lymphadenopathy.
前列腺癌是男性中最常见的癌症之一，在全球总体癌症负担中占很大比例。大多数患者表现为下尿路症状。转移至锁骨上淋巴结是一种不常见的表现，尤其是作为首发表现的情况很少被报道。我们报告了两例罕见的晚期前列腺腺癌病例，最初的主要症状是在胸锁乳突肌两头之间的左侧锁骨上区域出现质地坚硬、无压痛的肿块（即魏尔啸淋巴结）。对患者的检查显示前列腺特异性抗原（PSA）水平升高至>100 ng/ml，通过对锁骨上淋巴结和前列腺活检进行组织学评估及PSA免疫染色确诊。该病例系列强调了在鉴别诊断男性锁骨上淋巴结肿大患者时考虑前列腺癌的重要性。
