A Case of Left Axirally Lymph Node Metastasis Resected 25 Years after the Diagnosis of Stage IV Lung Cancer

• Published in: Nihon Rinsho Geka Gakkai Zasshi (Journal of Japan Surgical Association) Vol. 75; no. 4; pp. 922 - 927
• Main Authors: CHUJO, Masao, ANAMI, Kentaro, KAMEI, Mirei
• Format: Journal Article
• Language: English; Japanese
• Published: Japan Surgical Association 2014
• Subjects: chemotherapy; primary lung cancer
• ISSN: 1345-2843; 1882-5133
• DOI: 10.3919/jjsa.75.922

A 67-year-old man who had undergone chemoradiotherapy with the diagnosis of Stage IV lung cancer at the age of 42, followed by left upper lobectomy at the age of 49 was seen at our hospital because of short of breath. He was diagnosed with respiratory failure due to chronic obstructive pulmonary disease. At that time, a chest CT scan revealed a 4×3 cm irregular shaped tumor at the left axilla. FDG-PET showed abnormal uptake of FDG in the same area. A biopsy resulted in lymph node metastasis of cancer. Its histopathological features were the same as those of previous lung cancer. We diagnosed the case as left axillary metastasis of lung cancer and performed six courses of chemotherapy with cisplatin + pemetrexed sodium hydrate. Following the chemotherapy, the tumor slightly decreased in size and PET showed no abnormal uptake of FDG. Since no other lesions suggestive of metastasis were demonstrated on imaging procedures, the tumor was removed. Remnant tumor cells were absent in the resected specimen. We did not employ adjuvant chemotherapy and followed his clinical course. No signs of recurrence had been seen, but his underlying disease chronic respiratory failure progressed to cause cor pulmonale. He passed away about two years after the removal of the left axillary lymph node involved.