BACKGROUND Carcinoma prostate is one of the most common cancer in an elderly male. With the peak incidence between 70 and 74 years of age, less than 1% of patients with prostate cancer are younger than 50 years of age. Metastasis from prostate cancer occurs via local spread, lymphatic spread and haematogenously to the axial skeleton. Here, we present a case report of advanced prostate cancer presenting as cervical lymph node enlargement, which is a rare presentation.