We report the case of a 53-year-old patient who consulted for presenting left cervical latero mass, abdominal pain and diarrhea. Physical examination revealed a mamelon rectal mucosa, irregular, with a 3 x 2 left lobe adhering to a painful mass.
A cervical lymph node biopsy was performed, reporting metastatic prostatic disease, with positive tumour cells in the immunohistochemical study for the antigen proNA specific adenocarcinoma (100%), cytokeratin AE1/AE3 and PC
Prostate specific antigen serum reported 738.4 ng/ml and free PSA 92.8 ng/ml.
Placement of a groove showing up to 25 cm of the anal margin, edematous, erythematous, friable, irregular surface folds was performed. Biopsy showed poorly differentiated carcinoma in the necrotic focus.
Prostatic biopsy reported poorly differentiated prostate adenocarcionama Gleason 6 (3+3).
A bone gammagram was performed which was positive with lesions located in the dorsal and lumbar spine.
The rest of the studies included abdominal ultrasound, neck, chest, abdomen and pelvis with double contrast, and showed pre- and bilateral abdominal aortic lymphadenopathies, with no evidence of thoracic lesions.
In view of the clinical and paraclinical findings that the patient has a stage T4 N2 M prostate adenocarcinoma. Consequently, treatment is indicated for advanced prostate cancer, performing orchiectomy bilateral socioeconomic condition.
