Conclusions:
Our case highlights the importance of investigating a PSA level when malignancy is suspected in an elderly male patient regardless of the initial presenting tumor site or symptom. Though such extensive metastasis usually yields a poor prognosis, our patient had dramatic improvement with prompt initiation of treatment. The patient’s generalized lymphadenopathy- particularly enlarged right supraclavicular lymph node, likely reactive secondary to COVID-19 immunization, prompted further imaging and biopsy thereby leading us to his diagnosis of metastatic prostate adenocarcinoma which may have otherwise gone undetected until further disease progression.