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BACKGROUND: Virchow’s node is a common site for metastasis in cancers of the stomach and pancreas. It is rarely involved in hepatocellular carcinoma. METHOD: We report on a patient with hepatoma who had metastasis to the left supraclavicular node at presentation. RESULTS: This 25-year-old man presented with abdominal pain, fever, weight loss, hard nodular hepatomegaly and a hard, fixed left supraclavicular lymphadenopathy. He was hepatitis B surface antigen positive, had elevated serum alpha-fetoprotein levels, and transabdominal imaging showed a space-occupying lesion in the right lobe of the liver. Fine needle aspiration of the left supraclavicular node revealed a poorly differentiated carcinoma. CONCLUSION: Metastasis to the Virchow-Trosier node in hepatoma, although uncommon, can occur probably via the hepatic node and then through the thoracic duct.
BACKGROUND: Virchow’s node is a common site for metastasis in cancers of the stomach and pancreas. It is rarely involved in hepatocellular carcinoma. METHOD: We report on a patient with hepatoma who had metastasis to the left supraclavicular node at presentation. RESULTS: This 25 -year-old man presented with abdominal pain, fever, weight loss, hard nodular hepatomegaly and a hard, fixed left supraclavicular lymphadenopathy. He was hepatitis B surface antigen positive, had elevated serum alpha-fetoprotein levels, and transabdominal imaging showed a space- occupying lesion in the right lobe of the liver. Fine needle aspiration of the left supraclavicular node revealed a poorly differentiated carcinoma. CONCLUSION: Metastasis to the Virchow-Trosier node in hepatoma, although uncommon, can occur via the hepatic node and then through the thoracic duct.