Metastasis of hepatocellular carcinoma to Virchow's node: have the tumor cells gone astray?
BACKGROUND
Virchow's node is a common site for metastasis in cancers of the stomach and pancreas. It is rarely involved in hepatocellular carcinoma.


METHODS
We report on a patient with hepatoma who had metastasis to the left supraclavicular node at presentation.


RESULTS
This 25-year-old man presented with abdominal pain, fever, weight loss, hard nodular hepatomegaly and a hard, fixed left supraclavicular lymphadenopathy. He was hepatitis B surface antigen positive, had elevated serum alpha-fetoprotein levels, and transabdominal imaging showed a space-occupying lesion in the right lobe of the liver. Fine needle aspiration of the left supraclavicular node revealed a poorly differentiated carcinoma.


CONCLUSIONS
Metastasis to the Virchow-Trosier node in hepatoma, although uncommon, can occur probably via the hepatic node and then through the thoracic duct.
Selvasekaran
Raja
R
Department of Gastroenterology, Stanley Medical College & Hospital, Chennai, India.
Cherian
Jijo Velliyappillil
JV
Venkataraman
Jayanthi
J
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000473:pathology*; D002968:Clavicle; D006801:Humans; D008113:Liver Neoplasms / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology*; D008297:Male