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Mediastinal Lymph Node Metastasis Without Liver or Lung Involvement After Curative Resection of Colon Cancer
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A4112 - Mediastinal Lymph Node Metastasis Without Liver or Lung Involvement After Curative Resection of Colon Cancer
Author Block: D. Park, T. Park, J. Moon, S. Kim, T. Kim, J. Sohn, H. Yoon; Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea, Seoul, Korea, Republic of.
Colon cancer usually spreads the regional lymph nodes, liver, lung, bone and brain. Metastasis to mediastinal lymph node without pulmonary and hepatic metastasis from colon cancer is very rare. Here, we report a case with multiple metastasis to mediastinal lymph nodes without any other organ involvement after curative resection of colon cancer. A 47 year-old man presented with abdominal pain, and colonoscopic biopsy were consistent with the diagnosis of colon adenocarcinoma. Subsequently, right hemicolectomy was performed, and histopathology revealed moderately to poorly differentiated adenocarcinoma of right colon with perineural and lymph‑vascular invasion, and metastatic involvement of 9 out of 22 regional lymph nodes. There was no distant metastasis on computed tomography scans of chest and abdomen, and the patient received chemotherapy with folinic acid, fluorouracil and oxaliplatin (FOLFOX). Two and a half years later, multiple enlarged mediastinal lymph nodes without lung and liver metastasis were observed on chest and abdomen computed tomography, and were extirpated by video-assisted thoracoscopic surgery. Pathology was consistent with the diagnosis of metastatic colonic primary adenocarcinoma. This case report suggests that the mediastinum should be considered as a possible metastatic site from colon cancer, even without evidence of lung and liver metastasis.
Author Block: D. Park, T. Park, J. Moon, S. Kim, T. Kim, J. Sohn, H. Yoon; Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea, Seoul, Korea, Republic of.
Colon cancer usually spreads the regional lymph nodes, liver, lung, bone and brain. Metastasis to mediastinal lymph node without pulmonary and hepatic metastasis from colon cancer is very rare. Here, we report a case with multiple metastasis to mediastinal lymph nodes without any other organ involvement after curative resection of colon cancer. A 47 year-old man presented with abdominal pain, and colonoscopic biopsy were consistent with the diagnosis of colon adenocarcinoma. Subsequently, right hemicolectomy was performed, and histopathology revealed moderately to poorly differentiated adenocarcinoma of right colon with perineural and lymph‑vascular invasion, and metastatic involvement of 9 out of 22 regional lymph nodes. There was no distant metastasis on computed tomography scans of chest and abdomen, and the patient received chemotherapy with folinic acid, fluorouracil and oxaliplatin (FOLFOX). Two and a half years later, multiple enlarged mediastinal lymph nodes without lung and liver metastasis were observed on chest and abdomen computed tomography, and were extirpated by video-assisted thoracoscopic surgery. Pathology was consistent with the diagnosis of metastatic colonic primary adenocarcinoma. This case report suggests that the mediastinum should be considered as a possible metastatic site from colon cancer, even without evidence of lung and liver metastasis.
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