title: Scalene lymph node metastases with the negative pelvic nodes in invasive cervical carcinoma.
abstract: Cervical carcinoma spreads predominantly by lymphatic routes and lymph node metastases may occur even in early stages of disease. Metastases usually first appear in pelvic lymph nodes, then disseminate along the efferent lymphatic chain to the extrapelvic lymph nodes. Cases of positive lymph node metastases with negative pelvic nodes in invasive cervical carcinoma are extremely rare. We report a 50-year-old woman with bulky stage IIA cervical carcinoma who had scalene lymph node metastases in the absence of pelvic lymph node metastases after radical hysterectomy and postoperative pelvic irradiation. This rare "skipping" nodal metastasis was probably via posterior trunk lymphatic drainage of the bulky cervical carcinoma which mainly invaded the posterior vaginal cuff. Neoadjuvant or adjuvant chemotherapy is recommended to prolong survival of patients in such cases.
authors.affiliation: Department of Obstetrics and Gynecology, College of Medicine and Hospital, National Taiwan University, Taipei, ROC.
authors.forename: Y L
authors.initials: YL
authors.lastname: Mai
authors.forename: H H
authors.initials: HH
authors.lastname: Lin
authors.forename: D Y
authors.initials: DY
authors.lastname: Chang
authors.forename: C K
authors.initials: CK
authors.lastname: Chen
authors.forename: W F
authors.initials: WF
authors.lastname: Cheng
authors.forename: G C
authors.initials: GC
authors.lastname: Tseng
authors.forename: S C
authors.initials: SC
authors.lastname: Huang
mesh_terms: D002294:Carcinoma, Squamous Cell / Q000473:pathology*; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis; D008875:Middle Aged; D009333:Neck; D009361:Neoplasm Invasiveness; D010388:Pelvis; D002583:Uterine Cervical Neoplasms / Q000473:pathology*