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Vol.61 No.2 contents | Japanese/English |
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- Case Report -
Four Cases of Mediastinal Lymph Node Carcinoma of Unknown Primary Site After Chemoradiotherapy with a Long Survival
Ryoko Ohnishi1, Tatsuo Kato1, Koichi Asano1, Toshitaka Suzuki1, Yoshihiko Matsuno1, Shigeo Yasuda1, Akira Hara21Department of Respiratory Medicine, National Organization Hospital Nagara Medical Center, Japan, 2Department of Tumor Pathology, Gifu University Graduate School of Medicine, Japan
Background. Standard therapy for unresectable cases of mediastinal lymph node carcinoma of unknown primary site has not been established. Cases. Case 1. A 59-year-old man underwent computed tomography (CT) that showed right paratracheal lymphadenopathy. The lymphadenopathy was diagnosed as adenocarcinoma by endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA). He was treated with chemoradiotherapy successfully, but squamous cell carcinoma appeared in the lower lobe of the right lung 10 years later. Case 2. A 70-year-old man was found to have left paratracheal lymphadenopathy. The lymphadenopathy was diagnosed as adenosquamous carcinoma by mediastinoscopy. Chemoradiotherapy was successful, but squamous cell carcinoma appeared in the lower lobe of the left lung 7 years later and was resected. Case 3. A 71-year-old man was found to have swelling of the right paratracheal lymph node during follow-up of combined pulmonary fibrosis and emphysema. The lymphadenopathy was diagnosed as adenocarcinoma by EBUS-TBNA. He was treated with chemoradiotherapy and has been alive without recurrence for 10 years. Case 4. A 64-year-old man was found to have subcarinal lymph node swelling. The lymphadenopathy was diagnosed as squamous cell carcinoma by EBUS-TBNA. He received chemoradiotherapy and has been relapse-free for 5 years. Conclusion. Chemoradiotherapy with paclitaxel (PTX) and carboplatin (CBDCA) seems to be a promising treatment for unresectable cases of mediastinal lymph node carcinoma of unknown primary site. Lung cancer is likely to occur during the course, and careful follow-up is required.
key words: Mediastinal lymph node carcinoma, Cancer of unknown primary site, Chemoradiotherapy, Lung cancer
Received: April 10, 2020
Accepted: December 14, 2020
JJLC 61 (2): 119-124, 2021
