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Case Reports
. 2024 Apr 25;2024(4):omae027.
doi: 10.1093/omcr/omae027. eCollection 2024 Apr.

Unusual initial presentation of prostate adenocarcinoma with inguinal lymph nodes metastases: a case report

Maja Sofronievska Glavinov  1 , Rubens Jovanovic  2 , Venjamin Majstorov  3 , Jovo Burneski  4 , Andrej Nikolovski  5
Affiliations
Case Reports

Unusual initial presentation of prostate adenocarcinoma with inguinal lymph nodes metastases: a case report

Maja Sofronievska Glavinov et al. Oxf Med Case Reports. .

Abstract

The presence of lymph node metastases in prostate adenocarcinoma is a poor prognostic sign, and mortality rates are often high. Inguinal lymph node metastases are an unusual presentation of advanced disease, and they can be easily misinterpreted with other diseases. We present a case of a 63-year-old patient with no previous symptoms and signs of prostate disorder with a right-sided inguinal lump and abdominal pain. The CT scan showed right inguinal and retroperitoneal lymphadenopathy. Elevated PSA serum levels, digital rectal examination, and skeletal scintigraphy with 99mTc-MDP favored the diagnosis of metastatic prostate adenocarcinoma. Since the patient denied prostate biopsy, a dissection of the right inguinal nodes was performed. Histopathological findings confirmed metastatic prostate adenocarcinoma. The treatment was hormonal and bisphosphonate therapy, with objective posttreatment improvement. Based on this case, it can be concluded that inguinal and generalized lymphadenopathy are potential initial manifestations of metastatic prostate adenocarcinoma in male patients.

Keywords: case report; inguinal lymphadenopathy; metastases; prostate adenocarcinoma.

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Conflict of interest statement

No conflict of interest.

Figures

Figure 1
Figure 1
(A) Enhanced computed tomography (CT) scan of the abdomen and pelvis, axial view, showing right inguinal lymphadenopathy (arrow). (B) Coronal view of the enhanced CT scan of the abdomen showing retroperitoneal lymphadenopathy (arrow).
Figure 2
Figure 2
Skeletal scintigraphy with 99mTc-MDP showing bone metastases (marked dark with concentrated radiotracer).
Figure 3
Figure 3
(A) Hematoxylin-eosin stain of lymph node metastasis. (B) Immunohistochemical staining positivity for PSA. (C) Immunohistochemical staining positivity for PAP.
See this image and copyright information in PMC

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