title: Lung cancer with isolated skip metastasis to an abdominal lymph node.
abstract: 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.
authors.affiliation: Division of Thoracic Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan, ROC.
authors.forename: Tsai-Wang
authors.initials: TW
authors.lastname: Huang
authors.forename: Ching
authors.initials: C
authors.lastname: Tzao
authors.forename: Deng-Wei
authors.initials: DW
authors.lastname: Chen
authors.forename: Wen-Chiuan
authors.initials: WC
authors.lastname: Tsai
authors.forename: Yung-Lung
authors.initials: YL
authors.lastname: Cheng
authors.forename: Shih-Chun
authors.initials: SC
authors.lastname: Lee
mesh_terms: 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
chemical_list: D019788:Fluorodeoxyglucose F18