Impact of middle and lower jugular neck dissection on supraclavicular lymph node metastasis from endometrial carcinoma
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WORLD JOURNAL OF SURGICAL ONCOLOGY
CASE REPORT
Open Access
Impact of middle and lower jugular neck dissection on supraclavicular lymph node metastasis from endometrial carcinoma Masataka Kojima, Junkichi Yokoyama*, Shin Ito, Shinichi Ohba, Mitsuhisa Fujimaki and Katsuhisa Ikeda
Abstract Supraclavicular lymph node metastasis from endometrial carcinoma is considerably rarer than metastasis from uterine cervical cancer. To date, there have been no reported cases regarding systematic neck dissection as a salvage treatment. In this report, we describe the neck dissection procedure carried out on a 74-year-old woman with supraclavicular lymph node metastasis. Our objective was to histologically determine the origin of the metastasis while simultaneously providing appropriate treatment. The patient’s past medical history included two prior cases of cancer: rectal cancer 7 years earlier and endometrial adenocarcinoma 4 years earlier. We determined that middle and lower jugular neck dissection was appropriate in treating this case based on the results of our preoperative FDG-PET and tumor markers. This surgery provided histological evidence that metastasis occurred from endometrial carcinoma. Middle and lower jugular neck dissection was expected to improve the patient’s prognosis without impacting the patient’s active daily life. We have continued to monitor the patient closely over an extended period. Keywords: Neck dissection, Thoracic duct, Cervical lymph node, Endometrial adenocarcinoma, Chyle fistula
Background Supraclavicular lymph node metastasis from uterine carcinoma is rare and has been shown to negatively affect a patient’s prognosis. If supraclavicular lymph node metastases is detected from cervical cancer of the uterine, there is the possibility of further distant metastasis occurring. Therefore, the prognosis of supraclavicular lymph node metastasis from uterine cervical cancer is considered significant. In such cases, palliative radiotherapy is the recommended treatment for relief of symptoms and improvement of the patient’s quality of life. Metastases of uterine carcinoma to the neck is reported to spread by way of the lymph flow from the pelvis up to the para-aortic nodes into the mediastinum, then into the thoracic duct [1]. There have been no cases reported regarding the use of systematic neck dissection for the treatment of left supraclavicular lymph nodes suspected of being endometrial adenocarcinoma * Correspondence: [email protected] Department of Otorhinolaryngology Head and Neck Surgery, Juntendo University Faculty of Medicine, 2-1-1, Hongo, Bunkyo-ku, Tokyo, Japan113-8421
metastasis before surgery. Neck dissection for the treatment of metastasis from endometrial adenocarcinomas is not an established procedure. The objective of our report is to consider the most effective method of neck dissection for the treatment of supraclavicular lymph nodes from endometrial carcinoma in relation to our patient.
Case presentation A 74-year-old woman underwent computed tomography (CT) as a follow-up p
