Resection of Colon Cancer and Its Metastases to the Virchow Lymph nodes in a patient with Sarcoidosis.

Hideki Yamada, Michiko Kanai, Katsura Hamaguchi, Hirotoshi Ogawa, Yoriyuki Nakamura, Yasuhiro Ohba, Junji Washizu, Tatsuharu Yamada, Chulho Park and Takashi Yano

Department of Surgery, Kasugai Municipal Hospital

A 60-year-old woman with 15-year sarcoidosis duration presenting with a tumor in the left supraclavicular fossa was found in aspiration biopsy to have moderately differenciated adenocaricinoma. Further investigation showed advanced transverse colon cancer with paraaortic (No. 216) and thoracic lymph node swelling. Under diagnosis of advanced transverse colon cancer with metastasis to the paraaortic and Virchow's lymph nodes and bilateral hilar lymphadenopathy (BHL) due to sarcoidosis, we conducted right hemicolectomy with D4 lymphadenectomy and left neck lymph node dissection. The resected lymph nodes at No. 222, No. 216a₂, and 216b₁ showed mixed cancer metastasis and sarcoidosis. The patient remains alive and well without recurrence 3 years and 11 months after surgery with peroral chemotherapy of carmofur (300 mg/day).
This good prognosis was due to both right hemicolectomy with D4 lymphadenectomy and left neck lymph node dissection and postoperative chemotherapy.

Key words
sarcoidosis, Virchow's metastasis, advanced colorectal cancer

Reprint requests
Hideki Yamada Department of Surgery, Kasugai Municipal Hospital 1-1-1 Takagi-cho, Kasugai-shi, 486-8510 JAPAN

Accepted
July 24, 2002

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