Metastatic Thoracic Lymph Node Carcinoma of Unknown Origin

Miyoshi, Kentaroh; Okumura, Norihito; Kokado, Yujiro; Matsuoka, Tomoaki; Kameyama, Kotaro; Nakagawa, Tatsuo

doi:10.2482/haigan.47.245

Cited by 14 publications

(7 citation statements)

References 11 publications

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“…Some reports have shown the effectiveness of surgery or chemoradiotherapy for treatment of mediastinal lymph node CUP [2] [4]- [9]. Miyoshi et al [5] reported surgical treatment for metastatic thoracic lymph node CUP. They divided their patients into two groups: those with single-station lymph node involvement (SS) and those with multiple-station lymph node involvement (MS).…”

Section: Discussionmentioning

confidence: 99%

Surgical Treatment for Mediastinal Lymph Node Carcinoma of Unknown Primary

Saito¹,

Nakagawa²,

Chiba³

et al. 2014

OJTS

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Carcinoma of unknown primary (CUP) is occasionally encountered in clinical oncology. Wide variation exists in CUP. We herein report a rare case of CUP of a mediastinal lymph node. A 61-year-old man with dermatomyositis was referred to our hospital for treatment of mediastinal adenopathy and gastric cancer. Biopsy of both lesions showed that they were histologically different from each other. Mediastinal lymphadenectomy and total gastrectomy were performed for a definitive diagnosis and radical cure. Pathological examination revealed two distinctly different disease processes. The patient underwent postoperative chemotherapy for residual gastric cancer. Twenty months postoperatively, he is alive with cancer. Although CUP usually has a poor prognosis, surgical treatment of metastatic mediastinal lymph node CUP is a feasible therapeutic option.

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Section: Discussionmentioning

confidence: 99%

Surgical Treatment for Mediastinal Lymph Node Carcinoma of Unknown Primary

Saito¹,

Nakagawa²,

Chiba³

et al. 2014

OJTS

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“…8) Morio et al 9) and Masaki et al 10) reported that the mean survival time of patients with hilar and mediastinal lymph node carcinoma was 28.9-30.7 months, and that the prognoses of these patients were more favorable than those of pN1 or pN2 lung cancer patients. Miyoshi et al 11) reported that multistation lesion cases have poor prognoses. Patients underwent concurrent chemoradiotherapy after biopsy, and all had died due to cancer within 1 year (mean survival time: 9.3 months).…”

Section: Discussionmentioning

confidence: 99%

Multimodal Treatment for Multistation Mediastinal Lymph Node Adenocarcinoma: A Case Report

Nakano

Endo

et al. 2012

ATCS

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We report on a 68-year-old male with a multistation mediastinal lymph node adenocarcinoma, who had no primary lesions occurring within 48 months. After diagnosis by lymph node biopsy via right-sided thoracoscopy, the bilateral mediastinal lymphadenopathy responded to platinum-based chemotherapy. At 30 months after completion of chemotherapy, left mediastinal lymphadenopathy recurred. Left anterior mediastinal dissection via leftsided thoracoscopy was successful. After surgery, the patient did well with no primary lesions for more than a year. The etiology of mediastinal lymph node carcinoma of unknown origin is discussed.

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“…Seventy cases of mediastinal LN carcinoma with an unknown primary site have been reported in Japan [9]. There is a male preponderance, and the overall male to female ratio is 4.4:1.…”

Section: Case Presentationmentioning

confidence: 99%

“…Mediastinal LN carcinoma with an unknown primary site is rare and comprises 1.5% of all cancers with unknown primary sites [ 1 - 3 ]. Seventy cases of mediastinal LN carcinoma with an unknown primary site have been reported in Japan [ 9 ]. There is a male preponderance, and the overall male to female ratio is 4.4:1.…”

Section: Case Presentationmentioning

confidence: 99%

“…Several cases have been reported in which radical excision of the mediastinal LN carcinoma resulted in a better prognosis than for the primary lung cancer with mediastinal LN metastasis [ 6 - 8 ]. In contrast, some cases with multiple mediastinal LN carcinomas with an unknown primary site, which were not eligible for radical excision, had a poor prognosis [ 9 ]. Although a useful chemotherapy has not been established for multiple LN carcinomas with an unknown primary site, platinum-based doublet chemotherapy has often been employed [ 10 , 11 ].…”

Section: Introductionmentioning

confidence: 99%

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Relapsed cervicomediastinal lymph node carcinoma with an unknown primary site treated with TS-1 alone: a case report

et al. 2013

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BackgroundCervicomediastinal lymph node carcinoma with an unknown primary site is quite rare, and useful treatment of these diseases has not been established. We report here the case of a patient successfully treated with TS-1 alone after the relapse of cervicomediastinal lymph node carcinoma with an unknown primary site.Case presentationA 62-year-old man was referred to our hospital because of cervicomediastinal lymph node swelling and high serum levels of carbohydrate antigen 19-9 and carcinoembryonic antigen. Fluorodeoxyglucose-positron emission tomography/computed tomography revealed an accumulation of fluorodeoxyglucose in the left supraclavicular lymph nodes, mediastinal lymph nodes, and the pelvic cavity. Colonoscopy revealed rectal cancer, which was diagnosed by biopsy as a tubular adenocarcinoma. Because metastases from rectal cancer to the cervicomediastinal lymph nodes are rare, the patient underwent thoracoscopic mediastinal lymphadenectomy. A biopsy specimen from the paraaortic lymph nodes demonstrated papillary adenocarcinoma that was pathologically different from the rectal cancer; therefore, a diagnosis of mediastinal carcinoma with an unknown primary site was established. The patient underwent low anterior resection of the rectum for the rectal cancer, and no abdominal lymph node metastasis (pMP, N0/stage I) was found. Although radiotherapy was performed for the cervicomediastinal lymph nodes, the mediastinal carcinoma relapsed after 6 months. Because the patient desired oral chemotherapy on an outpatient basis, TS-1 was administered at a dosage of 80 mg/day for 2 weeks, followed by a 1-week rest. TS-1 treatment resulted in a decrease in the size of the cervicomediastinal lymph nodes, and the serum tumor marker levels decreased to normal after the fourth course. The patient continued TS-1 treatment without adverse events and is currently alive without recurrence or identification of the primary site at the 32nd month after TS-1 treatment.ConclusionThis is the first reported case of relapsed cervicomediastinal lymph node carcinoma with an unknown primary site treated by TS-1 alone. TS-1 treatment for the carcinoma with an unknown primary site may be useful in patients who are not candidates for systemic platinum-based chemotherapy.

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Metastatic Thoracic Lymph Node Carcinoma of Unknown Origin

Cited by 14 publications

References 11 publications

Surgical Treatment for Mediastinal Lymph Node Carcinoma of Unknown Primary

Surgical Treatment for Mediastinal Lymph Node Carcinoma of Unknown Primary

Multimodal Treatment for Multistation Mediastinal Lymph Node Adenocarcinoma: A Case Report

Relapsed cervicomediastinal lymph node carcinoma with an unknown primary site treated with TS-1 alone: a case report

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