Diseases of the Colon & Rectum

, Volume 34, Issue 12, pp 1128–1130 | Cite as

Isolated spread of hepatic metastatic disease to a mediastinal lymph node

Report of a case and review of pertinent anatomy and literature
  • John T. Vetto
  • Alfred M. Cohen
Case Reports


The lymphatic system is an important route of spread of hepatic metastatic disease to extrahepatic sites. Although portal and celiac nodes are commonly evaluated both pre- and intraoperatively in patients considered for resection, cephalad sites of drainage of the liver represent a more occult pitfall. We report a case of colon cancer metastatic to the right lobe with an isolated extrahepatic deposit in a mediastinal lymph node. This preoperative diagnosis was confirmed at a subsequent operation, leading to a change in treatment plan. We believe that such occurrences may be unrecognized rather than rare. Careful evaluation of the mediastinum prior to proceeding with hepatic resection may improve patient selection, and hence the outcome, of this procedure.

Key words

Hepatic resection Lymphatic drainage Remetastasis 


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Copyright information

© American Society of Colon & Rectal Surgeons 1991

Authors and Affiliations

  • John T. Vetto
    • 1
  • Alfred M. Cohen
    • 1
  1. 1.Colorectal Service, Department of SurgeryMemorial Sloan-Kettering Cancer CenterNew York

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