Colon cancer metastasis to mediastinal lymph nodes without liver or lung involvement: A case report

El‑Halabi,Mustapha  M.; Chaaban,Said  A.; Meouchy,Joseph; Page,Seth; Salyers Jr,William  J.

doi:10.3892/ol.2014.2426

November-2014 Volume 8 Issue 5

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November-2014 Volume 8 Issue 5

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Case Report

Colon cancer metastasis to mediastinal lymph nodes without liver or lung involvement: A case report

Authors:
- Mustapha M. El‑Halabi
- Said A. Chaaban
- Joseph Meouchy
- Seth Page
- William J. Salyers Jr
View Affiliations / Copyright

Affiliations: Department of Internal Medicine, University of Kansas School of Medicine,Wichita, KS 67214, USA, Department of Internal Medicine, University of Kansas School of Medicine,Wichita, KS 67214, USA, Cancer Center of Kansas, Wichita, KS 67214, USA
Pages: 2221-2224
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Published online on: August 8, 2014

https://doi.org/10.3892/ol.2014.2426
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Abstract

Colon cancer is the second most common type of cancer in females and the third in males, worldwide. The most common sites of colon cancer metastasis are the regional lymph nodes, liver, lung, bone and brain. In this study, an extremely rare case of colon adenocarcinoma with extensive metastasis to the mediastinal lymph nodes without any other organ involvement is presented. A 44‑year‑old Caucasian male presented with abdominal pain, a change in bowel habits, melena and weight loss. Colonoscopy revealed a large friable, ulcerated, circumferential mass in the ascending colon. Biopsies were consistent with the diagnosis of invasive moderately differentiated adenocarcinoma. Subsequently, right colon resection was performed, and pathological analysis revealed moderately differentiated adenocarcinoma of the right colon with extensive regional lymph node involvement. Computed tomography (CT) scans of the chest, abdomen and pelvis were performed preoperatively as part of routine staging for colon cancer. No liver or lung pathology was identified; however, multiple pathologically enlarged mediastinal lymph nodes were observed. Endoscopic ultrasound with fine needle aspiration of the largest mediastinal lymph node, which measured 5.2x3.5 cm on CT scans, was performed. The pathology was again consistent with the diagnosis of metastatic colorectal primary adenocarcinoma. At present, no optimum treatment has been identified for metastatic colon cancer to the mediastinal lymph nodes. The patient in the current case received chemotherapy with folinic acid, fluorouracil and oxaliplatin (FOLFOX), as well as with bevacizumab. Initial follow‑up CT scans of the chest revealed a positive response to treatment. Physicians, in particular, radiologists, must consider the mediastinum during the first evaluation and further follow‑up of patients with colorectal carcinoma even in the absence of metastasis.

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Journals

International Journal of Molecular Medicine

International Journal of Oncology

Molecular Medicine Reports

Oncology Reports

Experimental and Therapeutic Medicine

Oncology Letters

Biomedical Reports

Molecular and Clinical Oncology

World Academy of Sciences Journal

International Journal of Functional Nutrition

International Journal of Epigenetics

Medicine International

Colon cancer metastasis to mediastinal lymph nodes without liver or lung involvement: A case report

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