A 42-year-old man was admitted for evaluation of a 3-month history of bilateral supraclavicular lymph nodes that crossed from level III to level IV.
A biopsy of a left supraclavicular lymph node identified a metastatic papillary adenocarcinoma without atypia; some rare follicular structures were filled with eosinophilic material that mimicked a colloid (figure 2).
The risk of microscopic invasion of the supraclavicular lymph nodes is largely influenced by the number of involved axillary nodes.
The axillary and supraclavicular lymph node stations are treated using an anterior field with or without a posterior axilla boost field to a total dose of 45-50 Gy in 1.
2,6] As such, it is rare to have distant metastasis to the supraclavicular lymph nodes without bone involvement or widespread systemic metastasis.
Enlargement of the supraclavicular lymph nodes as the initial sign of prostatic carcinoma.
Patients with respiratory compromise and small axillary or supraclavicular lymph nodes
should be aspirated with care (if at all), as a pneumothorax could prove fatal in these patients.
The most common locations for extrathoracic metastases include supraclavicular lymph nodes
, adrenal glands, liver, bone, and brain (12) (Figures 8, 9, and 10).
Clinical examination was unremarkable, with no evidence of an abdominal mass, hepatomegaly or left supraclavicular lymph nodes
The finding of distant metastases, in particular to the supraclavicular lymph nodes
, changes the treatment strategy for cervical cancer.
Distant metastases to the lung, liver, skin, and supraclavicular lymph nodes
have also been described.
Cervical non-supraclavicular lymph node
involvement was seen in 3 patients, and supraclavicular lymph nodes
in 4; pulmonary metastases occurred in 7, and liver metastases in 1 patient.