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Introduction <p>The rate of abdominal lymph node metastasis in the hepatoduodenal ligament is relatively low (0.95%) in patients with non-small-cell lung cancer (NSCLC). Moreover, solitary oligo-recurrence of the abdominal lymph node in the hepatoduodenal ligament after surgery for NSCLC is very rare. The definitive local therapy (DLT) for lung cancer oligo-recurrence is radiation therapy. However, surgical treatment can be prioritized under certain circumstances.</p> Case Presentation <p>A 75-year-old woman was referred to our hospital due to left lower lung cancer, and video-assisted thoracic surgery (VATS) left lower lobectomy with lymph node dissection (ND2a-2) was performed (defined as Day 0). The pathological diagnosis was papillary adenocarcinoma, pT2a, pN2, pM0, Stage IIIA. She underwent adjuvant chemotherapy with cisplatin (CDDP) and Vinorelbine (VNR) on postoperative month (POM) 1. On POM 36 a computed tomography (CT) scan found a significantly enlarged lymph node in the hepatoduodenal ligament without any tumors in the gastrointestinal tract. However, she declined chemotherapy for the lung cancer recurrence. On POM 60, the carcinoembryonic antigen (CEA) got above the normal limit, 8.1 ng/ml. A positron emission tomography (PET) revealed high fluorodeoxyglucose (FDG) uptake at this abdominal lymph node (maximum standardized uptake value (SUV-max), 15.6). No other metastases were detected. On POM63, exploratory laparotomy with lymph node dissection was performed. She was discharged on postoperative day 5 without any postoperative complications. The pathology of the enlarged lymph node was papillary adenocarcinoma stained positively for thyroid transcription factor 1 (TTF-1). Two years after the second surgery, she had no recurrence without adjuvant chemotherapy.</p> Conclusion <p>We present a rare case of solitary oligo-recurrence of an abdominal lymph node after surgery for NSCLC being surgically resected. DLT alone may contribute to long-term recurrence free survival without chemotherapy in carefully selected patients with solitary oligo-recurrence.</p>

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Surgical Resection for Solitary Oligo-Recurrence of the Abdominal Lymph Node in the Hepatoduodenal Ligament after Surgery for Non-Small-Cell Lung Cancer - a Case Report

  • 期刊论文

  • 发表日期：

    2026年2月20日

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  • Shinya Urakawa,
  • Daishi Yoshimura,
  • Kazuya Sakata,
  • Kimimasa Ikeda,
  • Naoto Kitahara,
  • Yoshihisa Kadota,
  • Satoru Miyazaki

摘要

Introduction

The rate of abdominal lymph node metastasis in the hepatoduodenal ligament is relatively low (0.95%) in patients with non-small-cell lung cancer (NSCLC). Moreover, solitary oligo-recurrence of the abdominal lymph node in the hepatoduodenal ligament after surgery for NSCLC is very rare. The definitive local therapy (DLT) for lung cancer oligo-recurrence is radiation therapy. However, surgical treatment can be prioritized under certain circumstances.

Case Presentation

A 75-year-old woman was referred to our hospital due to left lower lung cancer, and video-assisted thoracic surgery (VATS) left lower lobectomy with lymph node dissection (ND2a-2) was performed (defined as Day 0). The pathological diagnosis was papillary adenocarcinoma, pT2a, pN2, pM0, Stage IIIA. She underwent adjuvant chemotherapy with cisplatin (CDDP) and Vinorelbine (VNR) on postoperative month (POM) 1. On POM 36 a computed tomography (CT) scan found a significantly enlarged lymph node in the hepatoduodenal ligament without any tumors in the gastrointestinal tract. However, she declined chemotherapy for the lung cancer recurrence. On POM 60, the carcinoembryonic antigen (CEA) got above the normal limit, 8.1 ng/ml. A positron emission tomography (PET) revealed high fluorodeoxyglucose (FDG) uptake at this abdominal lymph node (maximum standardized uptake value (SUV-max), 15.6). No other metastases were detected. On POM63, exploratory laparotomy with lymph node dissection was performed. She was discharged on postoperative day 5 without any postoperative complications. The pathology of the enlarged lymph node was papillary adenocarcinoma stained positively for thyroid transcription factor 1 (TTF-1). Two years after the second surgery, she had no recurrence without adjuvant chemotherapy.

Conclusion

We present a rare case of solitary oligo-recurrence of an abdominal lymph node after surgery for NSCLC being surgically resected. DLT alone may contribute to long-term recurrence free survival without chemotherapy in carefully selected patients with solitary oligo-recurrence.