Abstract
Carcinoma of unknown primary (CUP) is occasionally encountered in clinical oncology. Wide variation exists in CUP. We herein report a rare case of CUP of a mediastinal lymph node. A 61-year-old man with dermatomyositis was referred to our hospital for treatment of mediastinal adenopathy and gastric cancer. Biopsy of both lesions showed that they were histologically different from each other. Mediastinal lymphadenectomy and total gastrectomy were performed for a definitive diagnosis and radical cure. Pathological examination revealed two distinctly different disease processes. The patient underwent postoperative chemotherapy for residual gastric cancer. Twenty months postoperatively, he is alive with cancer. Although CUP usually has a poor prognosis, surgical treatment of metastatic mediastinal lymph node CUP is a feasible therapeutic option.
Highlights
Carcinoma of unknown primary (CUP) is defined as biopsy-proven metastasis from a malignancy in the absence of an identifiable primary site after a thorough medical evaluation
CUP represents a heterogeneous group of cancer, and affected patients are divided into subsets of those with a favorable prognosis (20%) and those with an unfavorable prognosis (80%) [1]
A 61-year-old man with dermatomyositis was referred to our hospital because of mediastinal lymph node adenopathy that had been detected by computed tomography (CT)
Summary
Carcinoma of unknown primary (CUP) is defined as biopsy-proven metastasis from a malignancy in the absence of an identifiable primary site after a thorough medical evaluation. CUP constitutes as many as 3% to 5% of all cancer diagnoses [1]. CUP represents a heterogeneous group of cancer, and affected patients are divided into subsets of those with a favorable prognosis (20%) and those with an unfavorable prognosis (80%) [1]. Metastatic mediastinal lymph node CUP is a rare subset of CUP. It is not included in the favorable subset, but its prognosis is better than that in the unfavorable subset [2]. The optimal treatment strategy of this CUP subset has not yet been confirmed. (2014) Surgical Treatment for Mediastinal Lymph Node Carcinoma of Unknown Primary.
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