2021 Volume 61 Issue 1 Pages 50-53
Background. Primary peritoneal carcinoma, ovarian carcinoma, and fallopian tube carcinoma are known as mullerian adenocarcinoma. We herein report a case of peritoneal carcinoma with metastasis to the supradiaphragmatic lymph nodes. Case. The patient was a 78-year-old woman with dermatomyositis. Computed tomography (CT) performed to investigate interstitial pneumonia revealed a 34-mm mass on the right side and a 49-mm mass on the left side of the diaphragm, within the adipose tissue, as well as numerous masses around the inferior vena cava and iliac artery. Since positron emission tomography/CT (PET-CT) showed the accumulation of fluorodeoxyglucose (FDG) in the masses, malignant lymphoma was suspected. She was referred to our department for a biopsy and underwent thoracoscopic resection of the tumor on the right diaphragm. The pathological diagnosis was serous adenocarcinoma; thus, tumor metastasis from a gynecological organ was suspected. Laparoscopic bilateral adnexectomy and mesenteric tumor resection were performed in our gynecology department. A pathological examination revealed no malignant findings in the bilateral adnexa; however, the tumor in the mesentery was the same type as the tumor on the diaphragm. Ovarian cancer is reported to metastasize to the thoracic lymph nodes through the transdiaphragmatic route. In this case, the metastatic lesion on the diaphragm was thought to be the paracardiac group of superior diaphragmatic lymph nodes on the thoracic surface. Conclusion. When patients present with supradiaphragmatic swelling without lung lesions, in addition to malignant lymphoma, physicians should consider the possibility of metastasis of malignant tumors, such as primary peritoneal cancer.