The prognosis of prostate cancer mainly depends on the presence or absence of metastatic spread . Prostate cancer usually metastasises to the bony skeleton, followed by Liver 19.8%, Lung 13.1%, Peritoneum 3.6%, Adrenal 3%, brain/dura 3%
Most cases present with localized disease and have good prognosis. However, advanced metastatic prostate cancer commonly metastasizes to regional lymph nodes and vertebral bones, but metastasis lateral cervical lymph nodes is rare.
Important to recognize rare presentations metastatic disease, to obtain the correct diagnosis.
There are only 2 published cases
CLG 76 years-old, cardiopathy post-IMA , treaty with anticoagulants and antihypertensive drugs ,psa 178 ng/ml, palpable lateral cervical lymph nodes (LLC). T ac total negative body except for 4 lymph nodes Lc . Therefore, the patient undergoes at the department of otolaryngology Taranto to resection of adenopathy. Histology was suggestive of positive adenocarcinomatoide infiltrated with immunohistochemical markers, (cytokines) CK8 and CK18. Therefore, the patient was sent to us for appropriate assessment. The patient after rectal examination, was performative a transrectal prostate biopsy, under local anesthesia
They are executed only 4 needles for no patient compliance and its upward pressure until 190/85 mm / HGG and 108 bpm
The survey showed a clinical t2A, the biopsy Gleason 4 + 4 and 50 % of positive cores (those on the left). Scintigraphy t / B positive for secondarità 2 of radiopharmaceutical accumulation in the iliac crests
The patient, now has been put into bat ( bicalutamide + three-month Leuprorelina Acetato ) and if it evaluates the answer.
Lymphnodes are commonly involved during the course of metastatic prostate cancer. Hypogastric and
obturator lymph nodes as the most common sites.
This case reported, wanted examineted a atypical prostate cancer metastases cases. The
awareness of the manifestations of prostate cancer metastases may enable accurate diagnosis,
staging and help in appropriate management of disease. direct us to the correct diagnosis markers such as cytokines , that we used in this case. Cytokines CK8, CK18, are useful screening markers for the recognition of epithelial differentiation.( 9)
PanCKC (CK8/CK18/CK19) representing
epithelial cells. CK18, are also positively expressed by lung adenocarcinoma,
colorectal cancer (CRC), and prostate cancer (10)
Finally, in the case of prostate cancer, we combined PSA, because in the clinical application, immunohistochemistry for PSA is commonly used for In the diagnosis of
prostate cancer (10).
Prostate cancer should be always considered in the differential diagnosis
of elderly men presenting with supraclavicular lymphadenopathy, hydroureteronephrosis
or later cervical lymphadenopathy even in the presence of a normal digital rectal. PSA immunohistochemical staining should be used in doubtful cases. Obviously, prevention has its importance.
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Ifeanyi Ani, MD,* Mark Costaldi, MD,† and Robert Abouassaly, MD*
2.AJR:199, August 2012 Anant H. Vinjamoori, Jyothi P. Jagannathan, Atul B. Shinagare, Mary-Ellen Taplin, William K. Oh, Annick D. Van den Abbeele, Nikhil H. Ramaiya
3.Arab Journal of Urology (2013) 11, 48–53 Ahmed Elabbady, Ahmed Fouad Kotb
4. Int J Surg Case Rep. 2016; 23: 177–181. A 76 year old male with an unusual presentation of merkel cell carcinoma
Joel C. Acab,a,⁎ Wade Kvatum,a and Chukwuma Ebob
5.Br J Radiol. 1999 Oct;72(862):933-41. Features of unusual metastases from prostate cancer. Long MA1, Husband JE.
6. World J Urol. 2015 Dec 22. [Epub ahead of print]
Update on histopathological evaluation of lymphadenectomy specimens from prostate cancer patients.
Conti A1, Santoni M2, Burattini L2, Scarpelli M3, Mazzucchelli R3, Galosi AB1, Cheng L4, Lopez-Beltran A5, Briganti A6, Montorsi F6, Montironi R
7.Can J Urol. 1994 Jul;1(3):55-9.
Unusual presentations of advanced prostate cancer.
Gulanikar A1, Lau P, Bell DG.
8.Semin Oncol. 1977 Mar;4(1):53-8.
Metastatic and histologic presentations in unknown primary cancer.
Nystrom JS, Weiner JM, Heffelfinger-Juttner J, Irwin LE, Bateman JR, Wolf RM
9. Arch Pathol Lab Med—Vol 132, March 2008 Undifferentiated Tumor, Immunohistochemistry—Bahrami et al 327
10. CANCER BIOLOGY & THERAPY 2016, VOL. 17, NO. 4, 430–438 Si-Hong Lua,b, Wen-Sy Tsaic, Ying-Hsu Changd, Teh-Ying Choue, See-Tong Pangd, Po-Hung Lind, Chun-Ming Tsaif, and