Diagnosis of metastatic prostate cancer by supraclavicular lymph node excision in a patient with persistent macroscopic hematuria: A case report.

A 72-year-old man, who was under regular urological care, was diagnosed with advanced prostate carcinoma, based on a biopsy of a supraclavicular lymph node. Despite rising PSA levels, the patient had negative results on digital rectal examination, negative repeat prostate biopsy, and prostate MRI showed no signs suggestive of malignancy. A PSMA PET/CT scan, which was not indicated for the patient during the diagnostic proces, would have facilitated the diagnostic workup, particularly in detecting metastases. This case highlights the need for a broad diagnostic approach and the use of all available diagnostic methods in the diagnosis of malignant diseases.