Shun-Ichi Imamura1, Haruko Suzuki. 1. Department of Otolaryngology, School of Medicine, Shinshu University, Matsumoto City, Japan. imamuras@res.yamanashi-med.ac.jp
Abstract
OBJECTIVES: A very rare case of cervical lymph node metastasis from the liver is reported. The clinical findings and the diagnosis of a metastasis to the head and neck from the isolated silent abdominal cancer are discussed. MATERIAL AND METHODS: The clinical and histopathological findings of a 56-year-old woman with a metastatic cervical lymph node of unknown origin are presented, together with a literature review of metastases from an occult abdominal primary. RESULTS: The primary site was identified as an undifferentiated cholangiolocellular carcinoma using immunostaining for anti-cytokeratin subclasses after autopsy. Fifty-two cases of head and neck metastases from an abdominal primary cancer were found and separately summarized according to the metastatic routes. CONCLUSIONS: When a metastatic neck cancer of unknown origin is diagnosed, it is very important to consider the possibility of a metastasis from an abdominal organ. Recognition of metastatic routes and their characteristics is helpful in the search for the occult abdominal primary site. Immunohistochemistry of the metastatic cancer may provide important information for identifying the primary site in cases of metastasis of an undifferentiated carcinoma.
OBJECTIVES: A very rare case of cervical lymph node metastasis from the liver is reported. The clinical findings and the diagnosis of a metastasis to the head and neck from the isolated silent abdominal cancer are discussed. MATERIAL AND METHODS: The clinical and histopathological findings of a 56-year-old woman with a metastatic cervical lymph node of unknown origin are presented, together with a literature review of metastases from an occult abdominal primary. RESULTS: The primary site was identified as an undifferentiated cholangiolocellular carcinoma using immunostaining for anti-cytokeratin subclasses after autopsy. Fifty-two cases of head and neck metastases from an abdominal primary cancer were found and separately summarized according to the metastatic routes. CONCLUSIONS: When a metastatic neck cancer of unknown origin is diagnosed, it is very important to consider the possibility of a metastasis from an abdominal organ. Recognition of metastatic routes and their characteristics is helpful in the search for the occult abdominal primary site. Immunohistochemistry of the metastatic cancer may provide important information for identifying the primary site in cases of metastasis of an undifferentiated carcinoma.