High-Burden Metastatic Prostate Cancer Mimicking Lymphoma: A Case of Extensive Lymphadenopathy

Rahmat  Cahyanur; Dimas  Priantono; Andree  Kurniawan; Fakhri  Rahman; Lam  Sihardo; Monik Ediana  Miranda; Nur  Rahadiani; Endang Farihatul  Izza

doi:10.18502/ijhoscr.v20i1.21019

Rahmat Cahyanur Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Dimas Priantono Department of Internal Medicine, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Andree Kurniawan Department of Internal Medicine, Faculty of Medicine, Universitas Pelita Harapan, Tangerang, Banten, Indonesia
Fakhri Rahman Department of Urology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Lam Sihardo Division of Digestive Surgery, Department of Surgery, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Monik Ediana Miranda Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Nur Rahadiani Department of Anatomical Pathology, Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia
Endang Farihatul Izza Faculty of Medicine, Universitas Indonesia, Dr. Cipto Mangunkusumo General Hospital, Jakarta, Indonesia

DOI: https://doi.org/10.18502/ijhoscr.v20i1.21019

Keywords: Metastatic prostate cancer; Lymphadenopathy; Chemotherapy; Hormonal therapy; Case report

Abstract

Supradiaphragmatic lymphadenopathy is a rare finding in prostate cancer. The occurrence of multiple lymphadenopathies forming a conglomerate that resembles lymphoma is also rarely encountered in prostate cancer diagnosis. We present the case of a 71-year-old man who has experienced bilateral leg swelling in the last four months. Multiple lymphadenopathies were detected in the intra-abdominal and supradiaphragmatic regions, along with several metastatic bone lesions. Histopathological and immunohistochemical evaluations confirmed a diagnosis of prostate adenocarcinoma, not otherwise specified (NOS), with a Gleason score of 4+3=7, classified as grade group III, indicating high-volume metastatic prostate cancer. The patient was treated with docetaxel and anti-androgen therapy. His condition was improved after eight cycles of chemotherapy, and his prostate-specific antigen (PSA) levels returned to normal.