Understanding Left Supraclavicular Lymph Node Swollen: A Rare yet Critical Indicator

The diagnosis and management of cancer can be a complex and challenging process, especially when it comes to identifying the primary source of metastasis in patients with left supraclavicular lymph node swelling. In this article, we will explore three cases that highlight the importance of considering a broader range of possibilities when faced with this rare yet critical indicator.

In our first case, a 78-year-old Japanese woman was diagnosed with cholangiocarcinoma after presenting with swollen left supraclavicular nodes. Further investigation revealed a second primary tumor, highlighting the need for thorough screening and evaluation. Similarly, two other cases involved patients with bladder carcinoma and prostate carcinoma, respectively, who were initially thought to have a single primary tumor.

In each of these cases, the presence of metastasis in the left supraclavicular node led to a prolonged and challenging diagnostic process. This is not surprising, given that metastasis from infradiaphragmatic tumors to this region is reported to be rare. However, it underscores the importance of considering alternative explanations for left supraclavicular lymph node swelling, particularly in patients with head and neck carcinoma.

In addition to clinical presentation, laboratory tests such as carbohydrate antigen 19-9 and alpha-fetoprotein levels can also play a crucial role in diagnosis. In our cases, these markers helped to support the diagnosis of cholangiocarcinoma in one patient and adenocarcinoma in another.

The take-home message from these cases is that left supraclavicular lymph node swelling should be treated as a critical indicator requiring thorough evaluation and consideration of alternative explanations. By doing so, healthcare providers can improve diagnostic accuracy, inform treatment decisions, and ultimately enhance patient outcomes.

In conclusion, the diagnosis of malignant infradiaphragmatic tumors following an initial finding of left supraclavicular node metastasis is a rare yet important phenomenon that requires careful consideration and evaluation. By understanding the importance of this indicator and considering alternative explanations, healthcare providers can improve diagnostic accuracy and inform treatment decisions for patients with left supraclavicular lymph node swelling.

Supraclavicular lymph node swollen