Metastatic prostate cancer presenting as incidental pelvic lymphadenopathy – a report of three cases with literature review

The presence of metastatic lymph nodes is a poor prognostic factor in patients with prostate cancer. Currently, there is no national prostate cancer screening program through prostate-specific antigen testing and the benefits of initiating such a scheme have not yet been proven. However, an informed choice program is in place, on request, for men over the age of 50, following discussion with a healthcare professional and an assessment of the potential benefits. This test is also available to men presenting with lower urinary tract symptoms. We report three cases in men who were imaged for non-specific reasons and found to have pelvic lymphadenopathy. The patients reported no urinary symptoms and all were subsequently diagnosed as metastases from a prostatic primary. As this diagnosis was not considered at an earlier stage, there was a delay in initiating appropriate treatments.