title: [Four cases of cancer of unknown primary site that manifested as mediastinal metastatic lesions].
abstract: We encountered 4 patients with cancers of unknown primary sites that were manifested by mediastinal lesions. Patient 1 was a 58-year-old man with enlarged superior mediastinal lymph nodes. An exploratory thoracotomy yielded a diagnosis of lymph node metastasis of poorly differentiated adenocarcinoma. The patient was treated with chemotherapy and radiation therapy. Patient 2 was a 68-year-old man with a tumor in the right superior mediastinum. A total resection of the tumor was performed through a thoracotomy. The diagnosis was lymph node metastasis of squamous cell carcinoma, and treatment consisted of irradiation. A tumor shadow in the right upper lobe appeared 14 months after the thoracotomy, and was considered to be a primary lesion requiring a right pneumonectomy. The patient died of hepatic metastasis 6 months after the second operation. Patient 3 was a 59-year-old man with mediastinal and hilar lymph node swelling. Mediastinoscopic findings resulted in a diagnosis of squamous cell carcinoma. Because of the patient's insistence, only radiation therapy was performed. Patient 4 was a 65-year-old woman with a tumor in the right superior mediastinum who underwent a median sternotomy for total resection of the tumor. The pathological findings were strongly suggestive of metastasis of clear cell carcinoma. Patients 1, 3, and 4 were alive 33, 24, and 51 months, respectively, after their initial operation, without detectable primary sites. Patient 2 was considered to have had T 0 N 2 lung cancer.
authors.affiliation: Department of General Thoracic Surgery, Kochi Municipal Hospital, Japan.
authors.forename: F
authors.initials: F
authors.lastname: Chen
authors.forename: A
authors.initials: A
authors.lastname: Tatsumi
authors.forename: E
authors.initials: E
authors.lastname: Nii
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: H
authors.initials: H
authors.lastname: Muguruma
authors.forename: H
authors.initials: H
authors.lastname: Doi
authors.forename: T
authors.initials: T
authors.lastname: Nakayama
mesh_terms: D000230:Adenocarcinoma / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D018262:Adenocarcinoma, Clear Cell / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D000368:Aged; D002294:Carcinoma, Squamous Cell / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008479:Mediastinal Neoplasms / Q000473:pathology / Q000556:secondary* / Q000628:therapy; D008875:Middle Aged; D009367:Neoplasm Staging; D009382:Neoplasms, Unknown Primary; D016896:Treatment Outcome