Skip Navigation

Japanese Journal of Clinical Oncology 2006 36(12):827; doi:10.1093/jjco/hyl151
This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Supplementary data
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Sawada, M.
Right arrow Articles by Katsumata, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sawada, M.
Right arrow Articles by Katsumata, N.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


© 2007 Foundation for Promotion of Cancer Research

A Case of Primary Unknown Carcinoma with Lymphatic Spread

Morio Sawada and Noriyuki Katsumata

Gynecology Division and Breast and Medical Oncology Division,
National Cancer Center Hospital, Tokyo, Japan

A 51-year-old female was referred to our hospital for a further evaluation and treatment of a left inguinal tumor. An excisional biopsy of the left inguinal lymph nodes had revealed metastatic serous adenocarcinoma (Fig. 1). Extensive surveillance using computed tomography demonstrated massive lymph node metastases, but no other cancerous lesions. A F-18 fluorodeoxyglucose positron emission tomography (FDG-PET) showed FDG uptake in the para-aortic lymph nodes and in the left-sided pelvic lymph nodes, with maximum standardized uptake values from 5.2 to 5.5 (Fig. 2). Serum cancer antigen 125 level increased to 1330 U/ml. Following her gynecological screening adenocarcinoma cells were found in the cervical smear, but the primary lesion was not found in the uterus. Therefore, she was diagnosed as having a primary unknown carcinoma with lymphatic spread (stage IIIc).


Figure 1511
View larger version (162K):
[in this window]
[in a new window]
[Download PowerPoint slide]
  		Figure 1.
 

Figure 1512
View larger version (75K):
[in this window]
[in a new window]
[Download PowerPoint slide]
  		Figure 2.
 
She underwent six courses of neoadjuvant chemotherapy using a combination of Paclitaxel and Carboplatin. Because a significant reduction of the tumor-volume was observed after chemotherapy, she underwent debulking surgery, including the para-aortic pelvic lymph node dissection, left-sided pelvic lymphadenectomy, simple hysterectomy, salpingo-oophorectomy and omentectomy. Microscopically, serous adenocarcinoma was found in the para-aortic lymph nodes, the left pelvic lymph nodes and lymphatic vessels of the uterus, however, the primary site could not be identified owing to the severe degeneration of the specimen as a result of the chemotherapy. She underwent three courses of adjuvant chemotherapy using the same regimen with neoadjuvant chemotherapy. She is now doing well without recurrence 2 years after surgery. (Please note that a color version of Fig. 1 is available as supplementary data at http://www.jjco.oxfordjournals.org.)


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?



This Article
Right arrow Extract Freely available
Right arrow FREE Full Text (PDF) Freely available
Right arrow Supplementary data
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrow Request Permissions
Google Scholar
Right arrow Articles by Sawada, M.
Right arrow Articles by Katsumata, N.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Sawada, M.
Right arrow Articles by Katsumata, N.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?