Chua Alfredo V, Chu Alvin Christopher S, Tawasil Ashraf A, San Juan Michael D
Division of Medical Oncology, Department of Medicine, University of the Philippines - Philippine General Hospital, Taft Avenue, Ermita, Manila 1000, Philippines.
Department of Laboratories, University of the Philippines - Philippine General Hospital, Manila 1000, Philippines.
Ecancermedicalscience. 2021 Sep 23;15:1295. doi: 10.3332/ecancer.2021.1295. eCollection 2021.
The most common presenting symptoms of prostate cancer, a common cancer in males worldwide, are lower urinary tract symptoms. In rare cases, however, urinary symptoms may not be apparent, and patients can present with gastrointestinal symptoms instead. Even rarer is the involvement of non-regional lymph nodes such as the cervical nodes. Here, we report a case of a 50-year-old male who initially presented with constipation and an enlarging left lateral neck mass. Further work-up revealed metastatic prostatic adenocarcinoma and the patient dramatically responded to chemotherapy, androgen deprivation therapy and bone support therapy. This case highlights the importance of considering a prostate malignancy in a male patient presenting with gastrointestinal symptoms and a neck mass even in the absence of lower urinary tract symptoms. Serum prostate specific antigen, pathologic findings and immunohistochemistry staining are important to guide the clinician in making the correct diagnosis and treatment.
前列腺癌是全球男性常见的癌症，其最常见的症状是下尿路症状。然而，在罕见情况下，尿路症状可能不明显，患者可能反而出现胃肠道症状。更罕见的是出现非区域淋巴结受累，如颈部淋巴结。在此，我们报告一例50岁男性患者，最初表现为便秘和左侧颈部肿块增大。进一步检查发现为转移性前列腺腺癌，患者对化疗、雄激素剥夺治疗和骨支持治疗反应显著。该病例强调了即使在没有下尿路症状的情况下，对于出现胃肠道症状和颈部肿块的男性患者，考虑前列腺恶性肿瘤的重要性。血清前列腺特异性抗原、病理检查结果和免疫组化染色对于指导临床医生做出正确诊断和治疗至关重要。
