Mremi Alex, Mbwambo Orgeness J, Bright Frank, Mbwambo Jasper S, Mteta Kien A, Ngowi Bartholomeo N
Faculty of Medicine, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania; Department of Pathology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania.
Faculty of Medicine, Kilimanjaro Christian Medical University College, Box 2240, Moshi, Tanzania; Department of Urology, Kilimanjaro Christian Medical Centre, Box 3010, Moshi, Tanzania.
Int J Surg Case Rep. 2021 May;82:105889. doi: 10.1016/j.ijscr.2021.105889. Epub 2021 Apr 15.
Advanced prostate cancer often presents with lower urinary tract symptoms together with features of cancer on digital rectal examination. The commonest sites of metastasis include bone, liver and lungs. Metastasis to axillary lymph nodes is extremely unusual particularly as initial presentation of the disease.
We report an atypical case of a 40-year male patient presented with left axillary mass and normal initial urological evaluation. Histopathology and immunohistochemistry of the biopsies from the axillary mass and prostate confirmed the diagnosis of prostate adenocarcinoma. The patient declined anti-androgen monotherapy treatment and succumbed two months after establishment of the diagnosis.
Prostate cancer contributes significantly to the overall global cancer burden. 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. Therefore, clinical diagnosis of patients presenting with axillary lymphadenopathy may cause diagnostic delay. Careful physical and imaging examinations combined with pathological analysis are essential in the diagnosis of advanced prostate cancer with unusual presentation.
In theory, prostate cancer can cause metastatic spread to any part of the body. However, metastasis to axillary nodes has not been frequently noticed. Our report highlights the importance of considering prostate cancer among differential diagnoses in Afro-Caribbean males presenting with symptoms suggestive of chest and abdomino-pelvic cancer.
晚期前列腺癌常伴有下尿路症状，直肠指检可发现癌症特征。最常见的转移部位包括骨骼、肝脏和肺部。转移至腋窝淋巴结极为罕见，尤其是作为疾病的初始表现。
我们报告一例非典型病例，一名40岁男性患者，以左腋窝肿块就诊，初始泌尿外科评估正常。腋窝肿块和前列腺活检的组织病理学及免疫组化检查确诊为前列腺腺癌。患者拒绝抗雄激素单药治疗，确诊后两个月死亡。
前列腺癌在全球癌症总负担中占很大比例。前列腺癌转移至腋窝淋巴结是一种非常罕见的表现，文献中仅报道了少数病例。因此，对出现腋窝淋巴结病的患者进行临床诊断可能会导致诊断延迟。仔细的体格检查、影像学检查以及病理分析对于诊断表现不寻常的晚期前列腺癌至关重要。
理论上，前列腺癌可转移至身体的任何部位。然而，转移至腋窝淋巴结的情况并不常见。我们的报告强调了在对出现提示胸部和腹盆腔癌症症状的非洲加勒比男性进行鉴别诊断时考虑前列腺癌的重要性。
