[A Case of Solitary Inguinal Lymph Node Metastasis 15 Years after Colorectal Cancer Surgery].

The patient is a 69-year-old man. 17 years ago, a colectomy was performed for colorectal cancer, and a disseminated nodule was found during the operation, so the disseminated nodule was also resected. After the surgery, 12 courses of FOLFOX4 were administered, and there was no recurrence thereafter. He was diagnosed with hepatocellular carcinoma 12 years after the colectomy and underwent liver resection. Fifteen years after the colectomy, a mass shadow appeared in the right inguinal region, and inguinal lymph node metastasis of hepatocellular carcinoma or colorectal cancer was suspected. In the same year, he underwent the tumor resection and histopathological diagnosis revealed colon cancer inguinal lymph node metastasis. After the lymph node resection, he has been followed up for 2 years with no recurrence of colorectal cancer. It is extremely rare to have a solitary inguinal lymph node recurrence 15 years after colon surgery.

[Three Cases in Which Long-Term Survival Was Obtained by Irradiation for Postoperative Lymph Node Metastasis].

Case 1: Left total mastectomy was performed for a 58-year-old woman for diagnosis of left breast cancer. Seven years after surgery, left internal mammary node metastasis revealed. Irradiation was performed on the left chest wall and left supraclavicular area. Six months later, the lymph node swelling disappeared. Thereafter 8 years have passed without recurrence. Case 2: A 65-year-old man had a semi-emergency total gastrectomy for bleeding from gastric cancer. Three years after surgery, anterior pancreatic lymph node metastasis was detected. Radiation therapy was selected because his general condition was not so good. Three months later, lymph node swelling disappeared. Thereafter 4 and a half years have passed without recurrence. Case 3: A 67-year-old man underwent surgery for middle thoracic esophageal cancer after neoadjuvant chemotherapy. Seven months after surgery, left tracheobronchial lymph node metastasis was found. Irradiation was performed to bilateral supraclavicular area and mediastinum in combination with chemotherapy. Three months later, the lymph node normalized, and 6 and a half years have passed without recurrence. All 3 cases in this study were recurrences of regional lymph node. Radiation therapy may be effective for regional lymph node recurrence outside the dissected area or in areas that have been inadequately dissected.