泌尿器癌の頸部転移例の頸部郭清術 Neck Dissections for Genito-Urinary Carcinomas Metastatic to the Neck
Cervical lymph node metastases from genito-urinary neoplasms are rare. Left-sided neck metastases or supraclavicular metastasis are predominant because of the anatomy of the lymphatic system. Case 1 was a 23-year-old man with enlarged left supraclavicular lymph nodes. Biopsy was performed, revealing testicular cancer (teratocarcinoma). Subsequent computed tomography (CT) showed multiple large lymphadenopathies from cervical lymph nodes to retroperitoneal lymph nodes. Modified neck dissection was performed for metastatic testicular carcinoma after several courses of chemotherapy. As previously reported, no metastasis was found in levels I and II in our case.<br>In case 2, a 50-year-old man presented with an enlarged left supraclavicular lymph node. Biopsy specimen showed metastatic adenocarcinoma from the prostate. A subsequent CT showed no lymphadenopathy and no bone metastasis except for the neck metastases. Radical neck dissection was performed for prostatic carcinoma metastatic to the neck after radiotherapy. Metastases were found in every level from I-V and the left axillary lymph nodes in our case. In the case of prostatic metastasis, an aggressive and micrometastatic tendency was reported and it was difficult to detect micrometastases before surgery. We recommend radical neck dissection in neck metastases from prostatic carcinoma and selective neck dissection (levels III, IV, V) in neck metastases from testicular carcinoma.
耳鼻咽喉科臨床 95(3), 287-292, 2002-03-01