Isolated Mediastinal Lymph Node Metastasis of Anaplastic Carcinoma of Unknown Primary Origin: A Case Report

Nozomu Motono1*, Yoshimichi Ueda2, Akihiko Shioya3, Shinya Yamada4, Mashahito Ishikawa1, Shun Iwai1, Yoshihito Iijima1 and Hidetaka Uramoto1

1Department of Thoracic Surgery, Kanazawa Medical University, Japan 2Department of Pathology II, Kanazawa Medical University, Japan 3Department of Clinical Pathology, Kanazawa Medical University, Japan 4Department of Respiratory Medicine, Kanazawa Medical University, Himi Municipal Hospital, Japan

^*Correspondance to: Nozomu Motono 

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Abstract:

Background: Although some cases of anaplastic carcinoma of the thyroid gland, pancreas, or ovary have been reported, the anaplastic carcinoma of unknown primary origin is rare. Case Report: A 62-year-old man was detected with a mass in the mediastinal lymph node by computed tomography. Endoscopic ultrasound with bronchoscope-guided fine-needle aspiration for the mass from the esophagus was performed and was diagnosed as pleomorphic carcinoma. The patient was diagnosed with origin undetectable non-small cell lung cancer with clinical stage IIIA and subsequently received chemoradiotherapy. The lesion in the mediastinal lymph node was observed to shrink from 38 mm to 25 mm and left upper lobectomy plus mediastinal lymph node dissection was performed. Upon microscopic examination, the lesion in the mediastinal lymph node contained the solitary proliferation of large atypical cells with lobulated nuclei. Immunohistochemical stains of the pretherapy lesion showed that it was positive for Cytokeratin (CK) AE1/AE3, CK CAM5.2, CK 7, and epithelial membrane antigen. Furthermore, the lesion was negative for CK 20, vimentin, nuclear protein in testis, S100P, and leukocyte common antigen. Contrastingly, no significant lesion could be detected in the left upper lobe of the lung. Finally, the lesion was diagnosed as origin undetectable anaplastic carcinoma. Conclusion: We encountered a rare case of isolated mediastinal lymph node metastasis of anaplastic carcinoma of cancer of unknown primary origin that underwent chemoradiotherapy followed by surgery.

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Cite the Article:

Motono N, Ueda Y, Shioya A, Yamada S, Ishikawa M, Iwai S, et al. Isolated Mediastinal Lymph Node Metastasis of Anaplastic Carcinoma of Unknown Primary Origin: A Case Report. Ann Clin Case Rep. 2022; 7: 2195..