Volume 14, Number 4, December 2002
| | Unknown Primary Tumour Presenting as Bilateral Metachronous Cervical Lymph Node Metastasis and Lung Cancer: Immunohistochemical Studies |
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Atsushi Kohjitani,1 Takashi Yoshii,1 Shingo Wakatsuki,2 Shungo Furudoi,3 Osamu Teranobu,3 Takahide Komori3
1Department of Oral and Maxillofacial Surgery, Hyogo Prefectural Awaji Hospital, Shimogamo, Sumoto, Japan
2First Department of Pathology, Tokushima University School of Medicine, Kuramoto-cho, Tokushima, Japan
3Department of Oral and Maxillofacial Surgery, Kobe University Graduate School of Medicine, Kusunoki-cho, Chuo-ku, Kobe, Japan
Abstract
A patient with an occult primary cancer presenting as bilateral cervical lymphadenopathy and lung cancer is described. First, the mass in the left side of the neck was found to indicate squamous cell carcinoma. Second, a new mass appeared in the right side of the neck, which revealed adenosquamous carcinoma. Third, an asynchronously-appearing lung mass showed adenocarcinoma. All of these specimens showed positive immunoreactivity with cytokeratin-7 and carcinoembryonic antigen, and negative immunoreactivity with cytokeratin-20, surfactant apoprotein, and MOC-31. It is suggested that the primary tumour originated in the head and/or neck and metastasised to both sides of the neck and the lung. Bilateral neck irradiation may be useful for the treatment of this patient, even if the primary lesion has not been identified. The patient remains alive without local recurrence or distant metastasis, despite the poor prognosis for patients with cervical metastasis of unknown primary.
Key words: Adenosquamous carcinoma, Unknown primary cancer, Cervical metastasis
Asian J Oral Maxillofac Surg. 2002;14:240-244.
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