Obstet Gynecol Sci.  2018 Sep;61(5):626-630. 10.5468/ogs.2018.61.5.626.

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

• Kato T
• Seol KH
• Youn JS
• Hong DG

• KMID: 2426029
• DOI: http://doi.org/10.5468/ogs.2018.61.5.626

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.

Keyword

Cervical cancer; Lymphadenectomy; Recurrence; Computed tomography angiography

MeSH Terms

Angiography*
Aorta
Arteries
Female
Humans
Hysterectomy
Kidney
Lymph Node Excision*
Lymph Nodes
Pelvis
Radiotherapy, Adjuvant
Recurrence
Uterine Cervical Neoplasms*

Figure

• 

  Fig. 1 (A) Computed tomography (CT) image; arrows indicate the retro-crural metastatic lesions. (B) Three-dimensional (3D) CT angiography image, left side view; the purple color indicates the metastatic lesions. (C) 3D CT angiography image, anterior view. (D) 3D CT angiography image, posterior view.

• 

  Fig. 2 (A) Postoperative photography; arrows indicate the cut ends of left renal vein and left renal artery. (B) Resected retro-crural metastatic lymph node and left kidney; arrow indicates tumor invasion into the renal parenchyme.

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