Fine needle aspiration biopsy diagnosis of metastatic prostate carcinoma to inguinal lymph node

Carcinoma of the prostate is predominantly a disease of older men. Men younger than 50 years of age account for approximately 1% of all patients diagnosed with prostate cancer. Patients generally present with urinary symptoms and rarely with metastatic disease. Lymphatic spread typically occurs to the obturator and internal iliac nodes. We report a case of an aggressive prostate adenocarcinoma in a 47-year-old white male who presented with nausea, vomiting, and enlarged inguinal lymph nodes for 1 month. A fine needle aspiration biopsy (FNAB) and immunohistochemical stains performed on the FNAB revealed metastatic prostatic adenocarcinoma. The initial clinical presentation of inguinal lymphadenopathy, the age of the patient and the cytologic features made this an unusual case.