Contralateral Cervicomediastinal Lymph Node Metastases from Clinically Occult Adenocarcinoma of the Lung

• Published in: Clinical lung cancer Vol. 10; no. 4; pp. 249 - 251
• Main Authors: Hoshikawa, Mayumi, Mochizuki, Hideaki, Saito, Mio, Noguchi, Toshiyuki, Sawabe, Motoji, Takahashi, Hideki
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.07.2009
• Subjects: ACUP; Adenocarcinoma of unkown primary; Aged; Carcinoma, Signet Ring Cell - pathology; Diagnosis, Differential; Female; Hematology, Oncology and Palliative Medicine; Humans; Lung Neoplasms - pathology; Lymphatic Metastasis - diagnosis; Neoplasm Staging; Positron-Emission Tomography - methods; Pulmonary/Respiratory; Signet-ring cell carcinoma; Skip metastasis; Tomography, X-Ray Computed - methods; Adenocarcinoma of unkown primary; Skip metastasis; ACUP; Signet-ring cell carcinoma
• ISSN: 1525-7304; 1938-0690
• DOI: 10.3816/CLC.2009.n.034

Abstract A 69-year-old woman with a right cervical lymphadenopathy presented with an adenocarcinoma on excisional biopsy. Computed tomography (CT) scans and a positron emission tomography scan demonstrated that the tumor was localized in the right paratracheal and cervical region. A clinical diagnosis of lung cancer arising from an unknown primary site was made based on the radiologic and immunohistochemical findings. Serial CT scans showed a growing nodule in the left apex from pinpoint size to 1 cm in diameter after several months, which was defined as the primary site at autopsy. The finding of a clinically occult lung cancer directly spreading to the contralateral mediastinal and cervical nodes by skipping ipsilateral hilar and mediastinal nodes is rare.