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Cervical lymphadenopathy as initial presentation of genito-urinary cancer

Head and neck cancers rank fifth amongst the most affected cancers in the world. Metastasis to cervical lymph nodes is primarily from sites in head and neck. About 1% of all malignant cervical adenopathies are encountered as metastasis from remote primary site. We present here our experience of four cases in last five years. Patients presented as cervical lymphadenopathy with unknown primary, which on evaluation was found to be of genitourinary source from different sites. It is a single centre retrospective study. We reviewed cancer registry. We found four cases of genitourinary cancer with cervical lymph node metastasis. Patients presented as cervical lymphadenopathy of unknown primary. Among those one papillary renal cell cancer with rhabdoid differentiation, one testicular cancer, two prostate cancer. One case was a 67 year male patient, who revealed papillary renal cell carcinoma with rhabdoid features. Another patient was a male of 31 years, who had left testicular mass with retroperitoneal and cervical lymphadenopathy. Two patients of 68 year and 74 year respectively had metastatic prostate cancer. All patients underwent proper treatment and regularly followed up. Although rare, malignant cervical lymphadenopathy may be the first clinical manifestation of metastasis from genitourinary tumors. Evaluation of genitourinary system must be included in the protocol for uncovering the primary tumor site in cases of isolated cervical adenopathy. 