Lung cancer with isolated skip metastasis to an abdominal lymph node.
BACKGROUND
Lung cancer is usually diagnosed at an advanced stage with metastases present in 40% of patients. The preferential sites of extrapulmonary spread include lymph nodes, liver, brain, adrenal gland, and bone. Direct lymphatic metastases to abdominal lymph nodes without involvement of lobar, hilar or mediastinal lymph nodes is rare.


METHODS
We report a case of adenocarcinoma of the lung in the left lower lobe, with isolated metastasis to an abdominal lymph node detected by positron emission tomography (PET), followed by confirmation with surgical exploration.


CONCLUSIONS
The low incidence reported for skip metastasis to the abdominal lymph nodes may be attributed to an underestimation in the past. With the advent of PET computed tomography (PET-CT) and its use as a standard pre-operative staging modality for lung cancer, one should anticipate an increased incidence of skip metastasis.
Huang
Tsai-Wang
TW
Division of Thoracic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
Tzao
Ching
C
Chen
Deng-Wei
DW
Tsai
Wen-Chiuan
WC
Cheng
Yung-Lung
YL
Lee
Shih-Chun
SC
D000005:Abdomen; D000230:Adenocarcinoma / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D001706:Biopsy; D005260:Female; D019788:Fluorodeoxyglucose F18; D006801:Humans; D033162:Incidental Findings; D008168:Lung / Q000000981:diagnostic imaging / Q000473:pathology; D008175:Lung Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology / Q000601:surgery; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging* / Q000473:pathology; D008875:Middle Aged; D009367:Neoplasm Staging; D049268:Positron-Emission Tomography; D014057:Tomography, X-Ray Computed
D019788:Fluorodeoxyglucose F18