Cervical lymph node enlargement as the initial manifestation of rectal cancer

Abstract

Background Colorectal cancer is a very common malignant tumor worldwide. The clinical manifestations of advanced colorectal cancer include the changes in bowel habits, hematochezia, diarrhea, local abdominal pain and other symptoms. However, the colorectal cancer with an initial symptom of cervical lymph node enlargement is extremely rare. In this article, we report a case of rectal cancer presenting with cervical lymph nodes enlargement as the initial symptom. Case presentation A 57-year-old woman was admitted to our hospital for cervical lymph node enlargement which was accidentally detected during physical examination. Computed tomography scan revealed multiple enlarged lymph nodes in the neck. Cervical ultrasound showed normal thyroid gland and multiple left supraclavicular lymph nodes enlargement. The patient underwent lymph nodes biopsy and pathologic results showed metastatic adenocarcinoma. The subsequent lower gastrointestinal endoscopy revealed a mucosal bulge lesion located at rectus and biopsy revealed adenocarcinoma. The patient underwent rectal cancer resection. She is alive with no evidence of recurrence or new tumors 2 years after surgery. Conclusions Cervical lymph node metastasis is a rare metastatic way in colorectal cancer. This is the first case of rectal cancer presenting with cervical lymph nodes metastases as the initial symptom. Surgical resection combined with postoperative chemotherapy improved long-term prognosis of the patient. This rare metastatic way of rectal cancer should be paid attention for clinicians.

Sirtuin 2 up‐regulation suppresses the anti‐tumour activity of exhausted natural killer cells in mesenteric lymph nodes in murine colorectal carcinoma

“…27,28 Therefore, we turned our focus to mLN NK cells because malignant CRC cells frequently migrate into mesenteric lymph nodes. [29][30][31] Metastatic CRC cells might constitute a cancer microenvironment in mLNs to alter NK cell activity. As a result, we revealed Sirt2 up-regulation in mLN NK cells especially exhausted NK cells.…”

“…Other studies also reported the scarcity of NK cell infiltrates in the colon tissues of AOM/DSS‐treated mice 27,28 . Therefore, we turned our focus to mLN NK cells because malignant CRC cells frequently migrate into mesenteric lymph nodes 29–31 . Metastatic CRC cells might constitute a cancer microenvironment in mLNs to alter NK cell activity.…”

Management of Surgically Accessible Lymph Nodes Beyond Normal Resection Planes

“…The follow-up, when provided, ranged from 4 months to 2 years with near complete resolution of disease to no evidence of recurrence. 66 67 68 69 70 Several other case reports describe the finding of a metachronous metastatic cervical node after a colorectal resection for adenocarcinoma. Again, the treatment varied significantly from surgery, chemotherapy, or radiotherapy alone or a combination of treatments.…”

Laterocervical lymph node metastases from suspected thyroidal primary site that turned out to be metastases of lung cancer: A case report

“…Cervical lymphadenopathies of unknown primary are a special challenge 1 . Most of them come from primary cancer of the head and neck, but sometimes the primary is in a remote site 2 . These cases pose a diagnostic challenge, especially when the cytology from the enlarged nodes does not clearly suggest a site of origin.…”

“… 1 Most of them come from primary cancer of the head and neck, but sometimes the primary is in a remote site. 2 These cases pose a diagnostic challenge, especially when the cytology from the enlarged nodes does not clearly suggest a site of origin. In this report, we present a case of an asymptomatic man with cervical lymph node metastasis, suspected to be from a thyroidal primary site during an ultrasound screening program.…”