title: Solitary recurrence of hilar cholangiocarcinoma in a mediastinal lymph node two years after curative resection.
abstract: We recently encountered an unusual case of hilar cholangiocarcinoma in which a solitary recurrence in a mediastinal lymph node occurred two years after curative resection of the primary tumor. A 64-year old woman was admitted to our hospital with a complaint of right hypochondrial discomfort. After imaging studies demonstrated a hilar cholangiocarcinoma in the left hepatic duct, a curative resection of the tumor was performed, consisting of a left hepatic lobectomy along with caudate lobectomy, regional lymph node dissection, and resection of the extrahepatic bile duct. No nodal metastasis was observed histologically. Two years after surgery, the patient was found to have a nodule in the posterior mediastinum, which was thoracoscopically resected. No other swollen lymph nodes, local recurrence, or distant metastasis were noted. Histologically, the nodule proved to be a metastatic lymph node, and adjuvant chemoradiation therapy was initiated. The patient remained well for the four years following her first operation and had no evidence of disease recurrence 28 mo after her second operation. To our knowledge, this case is the first report of solitary recurrence in a mediastinal lymph node after curative resection of hilar cholangiocarcinoma.
authors.affiliation: Department of Transplantation and Digestive Surgery, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki 852-8501, Japan. hae37010@ams.odn.ne.jp
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Ito
authors.forename: Yoshitsugu
authors.initials: Y
authors.lastname: Tajima
authors.forename: Fumihiko
authors.initials: F
authors.lastname: Fujita
authors.forename: Ryuji
authors.initials: R
authors.lastname: Tsutsumi
authors.forename: Tamotsu
authors.initials: T
authors.lastname: Kuroki
authors.forename: Takashi
authors.initials: T
authors.lastname: Kanematsu
mesh_terms: D001650:Bile Duct Neoplasms / Q000473:pathology / Q000601:surgery*; D001653:Bile Ducts, Intrahepatic; D018281:Cholangiocarcinoma / Q000175:diagnosis* / Q000556:secondary; D003131:Combined Modality Therapy; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000601:surgery; D008207:Lymphatic Metastasis; D008479:Mediastinal Neoplasms / Q000175:diagnosis* / Q000556:secondary; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000556:secondary