Salvage para-aortic lymphadenectomy in recurrent cervical cancer after visualization with 3-dimensional computed tomography angiography.

Tomoyasu Kato, Ki Ho Seol, Jung Soo Youn, Dae Gy Hong
Author Information
  1. Tomoyasu Kato: Department of Gynecology, National Cancer Center Hospital, Tokyo, Japan.
  2. Ki Ho Seol: Department of Radiation Oncology, Catholic University of Daegu, School of Medicine, Daegu, Korea.
  3. Jung Soo Youn: Department of Obstetrics and Gynecology, Kyungpook National University Medical Center, Daegu, Korea.
  4. Dae Gy Hong: Department of Obstetrics and Gynecology, Kyungpook National University Medical Center, Daegu, Korea. ORCID

Abstract

We report a case of salvage lymphadenectomy for an isolated metastatic lesion in the para-aortic lymph node (LN) in a 49-year old woman with a history of cervical cancer, initially treated with radical hysterectomy and adjuvant radiotherapy. Preoperative 3-dimensional (3D) computed tomography (CT) angiography clearly revealed a huge retro-crural metastatic LN with distinct demarcation. A metastatic lesion, more than 10 cm in size, was located behind the vena cava, aorta, and left kidney, encompassing the left renal and lumbar arteries. The metastatic LN was excised along with the left kidney. On histologic examination, the tumor was found to have invaded the pelvis of the left kidney. Compared with conventional imaging techniques, 3D CT angiography can more clearly visualize such lesions. Thus, 3D CT angiography provides useful anatomical information, such as the exact size and location, and provides clear visualization and demarcation.

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