Cervical Lymphadenopathy as the First Presentation of Sigmoid Colon Cancer

• Published in: Middle East journal of cancer Vol. 4; no. 4; pp. 185 - 188
• Main Authors: Bulent Aksel, Lutfi Dogan, Niyazi Karaman, Salim Demirci
• Format: Journal Article
• Language: English
• Published: Shiraz University of Medical Sciences 01-10-2013
• Subjects: Cancer; Cervical lymph node; Metastasis; PET/CT; Sigmoid colon
• ISSN: 2008-6709; 2008-6687

The most common metastatic sites for colorectal carcinomas include the liver,lungs, brain, bones and peritoneal surfaces. In this report, a case of sigmoid coloncarcinoma presented with cervical lymphadenopathy was detected with the help ofPET/CT. A 57 year-old male presented with a complaint of swelling on the left sideof his neck. Ultrasonographic examination of the neck revealed three hypoechoic,peripherally vascularized lymph nodes with the largest diameter of 3cm. The thyroidgland was normal. Fine needle aspiration biopsy was performed and the pathology resultwas a metastatic carcinoma. He underwent a PET/CT scan to search for the primarycarcinoma which showed increased standardized uptake value of 13.2 in the left colonand 10.8 in the left cervical region. Colonoscopy showed an ulcerated mass lesion withobstruction of the lumen in the sigmoid colon.The patient had an anterior resection ofthe sigmoid colon with simultaneous resection of cervical lymph nodes. There was noevidence of intra-abdominal dissemination during surgery. The lymph nodes removedfrom the neck were also reportedas metastatic adenocarcinoma. The patient underwentsix cycles of adjuvant FOL FOX chemotherapy regimen. The patient has remaineddisease free after nine months of follow-up. PET/CT was a quick, effective method forthe detection of the primary tumor in the sigmoid colon. In additional to colonicresection and systemic therapy, palliative local control can also be achieved with theexcision of metastatic lymph nodes in the neck.