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伴有宫颈鳞状细胞癌上纵隔淋巴跳跃转移的原发性肺腺癌:一例报告及文献复习

Primary lung adenocarcinoma harboring upper mediastinal lymphatic skip metastasis of cervical squamous cell carcinoma: A case report and literature review.

作者信息

Zhang Chi, Ye Guanchao, Wang Xiaojun, Huang Yu, Huang Quanfu, Liao Yongde

机构信息

Department of Thoracic Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei 430022, P.R. China.

出版信息

Oncol Lett. 2024 Aug 7;28(4):481. doi: 10.3892/ol.2024.14614. eCollection 2024 Oct.

Abstract

The upper mediastinal lymph nodes are a rare site of metastasis in early-stage cervical cancer, but they are a common site of metastasis in lung cancer. Notably, standard approaches for identifying the source of metastasis and subsequent treatment are currently lacking. The present study describes the case of a patient with primary lung adenocarcinoma harboring upper mediastinal lymphatic skip metastasis from cervical squamous cell carcinoma 2 years after a radical hysterectomy. During video-assisted thoracoscopic surgery, it was indicated that the patient had a tendency for metastasis to the upper mediastinal lymph nodes from the lung tumor. Pathological examination confirmed the presence of metastasis; however, it was confirmed to originate from cervical carcinoma, rather than lung adenocarcinoma. In conclusion, for patients with lung cancer and concurrent malignancies, metastatic lymph nodes discovered during surgery may originate from the previous malignancy. Surgical management of oligometastatic lymph nodes in the mediastinum can be a potential treatment option, albeit one that may necessitate the integration of adjuvant treatment modalities as warranted by the individual case.

摘要

上纵隔淋巴结是早期宫颈癌罕见的转移部位,但却是肺癌常见的转移部位。值得注意的是,目前缺乏用于确定转移来源及后续治疗的标准方法。本研究描述了一例原发性肺腺癌患者的病例,该患者在根治性子宫切除术后2年出现上纵隔淋巴结跳跃转移,转移灶源自宫颈鳞状细胞癌。在电视辅助胸腔镜手术中,提示该患者存在肺肿瘤转移至上纵隔淋巴结的倾向。病理检查证实存在转移;然而,证实转移灶源自宫颈癌,而非肺腺癌。总之,对于患有肺癌且合并其他恶性肿瘤的患者,手术中发现的转移性淋巴结可能源自先前的恶性肿瘤。纵隔寡转移淋巴结的手术管理可能是一种潜在的治疗选择,尽管这可能需要根据具体病例情况综合应用辅助治疗方式。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/7fa3/11332576/c2be5318291e/ol-28-04-14614-g00.jpg

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