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Vol.44 No.2 contents | Japanese/English |
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- Case Report -
Metastatic Hilar or Mediastinal Lymph Node Carcinoma of Unknown Primary Site
Akira Nagashima1, Makoto Nakagawa1, Takashi Yoshimatsu11Department of Chest Surgery, Kitakyushu Municipal Medical Center, Japan
Background. Cancer in hilar or mediastinal lymph nodes without a recognizable primary site is a rare clinical entity that has been described in several previous case reports. Its possible origins, treatment, and prognosis are unclear. We encountered two resected cases of metastatic hilar or mediastinal lymph node carcinoma in which the primary site was unknown. Case. Patient 1 was a 73-year-old man with a tumor in the right superior mediastinum. Total resection of the tumor was performed through a right thoracotomy. The intraoperative histological diagnosis was metastatic carcinoma in a lymph node, so mediastinal lymph node dissection was carried out. The final histological diagnosis was poorly differentiated, metastatic squamous cell carcinoma in the lymph node. In spite of various post-operative clinical examinations, the primary site was not determined. He received adjuvant radiotherapy to the mediastinum, and no further treatment. He is alive and well without recurrence or appearance of the primary site 6 years after resection. Patient 2 was a 54-year-old man with a left hilar mass. A total resection of the tumor was performed through a left thoracotomy. The intraoperative histological diagnosis was metastatic squamous cell carcinoma in a lymph node, so left upper lobectomy and systematic mediastinal lymph node dissection was carried out. The primary site was not found in resected left upper lobe. He received no further treatment, and is alive and well without recurrence or appearance of the primary site 7 months after resection. Conclusion. Good results may be obtained by operation for cancer in hilar or mediastinal lymph node with an unknown primary site.
key words: Cancer of unknown primary site, Mediastinal lymph node metastasis, Hilar lymph node metastasis, Squamous cell carcinoma, T0 lung cancer
Received: December 1, 2003
Accepted: February 9, 2004
JJLC 44 (2): 103-106, 2004
