Dilek DİNÇOL, Abdullah BÜYÜKÇELİK, Mutlu DOĞAN, Arzu ENSARİ, Dizbay Serpil SAK

Uzak lenf nodu metastazı ile başvuran iki prostat ve mide adenokarsinom olgusu

Primeri bilinmeyen kanserli olgular atipik klinik prezentasyon ile başvurabilirler. Sağ supradiyafragmatik lenf nodu (LN) metastazı ile başvuran hastada bunun hematojen LN metastazı olabileceği de düşünülmelidir. Hematojen LN metastazı ile prezente olan 68 yaşında prostat kanserli ve 60 yaşında mide kanserli iki olgu sunuldu. İlk olguda olduğu gibi primeri bilinmeyen kanserli erkek hastalarda prostat spesifik antijen (PSA) düzeyine ve serbest/total PSA oranlarına mutlaka bakılmalı, gerekirse metastatik LN'da immünohistokimyasal PSA boyaması yapılmalıdır. Yine, diğer olgudaki gibi hematojen LN metastazı sonrası lenfatikler aracılığıyla cilt metastazı gelişebilir; bu lezyonlar tedavi yanıtını değerlendirirken takip kriteri olarak kullanılabilir.

Two prostatic and gastric adenocarcinoma cases with distant lymph node metastasis

Cancer patients with unknown primary site may have different presentations. Hematogenous lymph node metastasis probability should be also considered when evaluating patients with right supradiaphragmatic lymph node metastasis. A 68-yearold male with prostatic carcinoma and a 60-year-old male with gastric carcinoma are presented here. The prostate specific antigen (PSA) levels and free/total PSA ratio should be measured in male cancer patients with unknown primary site, as we did in our first patient and immunohistochemical PSA staining in the metastatic lymph node, if necessary. Skin metastasis may occur with lymphatic spread after hematogenous lymph node metastasis, and these lesions might also be used as follow-up criteria for response to the treatment.

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