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Virchow’s node: a case report of an extremely rare presentation of metastasis of adenocarcinoma with mucinous features from the colon

Authors Suliman MS, Singh M, Ajmeri AN, Stuart DL, Teka ST

Received 15 January 2019

Accepted for publication 18 February 2019

Published 29 March 2019 Volume 2019:12 Pages 137—140

DOI https://doi.org/10.2147/IJGM.S201617

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Colin Mak

Peer reviewer comments 2

Editor who approved publication: Dr Scott Fraser


Mohamed S Suliman,1 Monider Singh,1 Aman Naim Ajmeri,1 David L Stuart,2 Samson T Teka1

1Internal Medicine, Joan C. Edwards School of Medicine, Marshall University, Huntington, WV, 25701, USA; 2Department of Surgery, Beckley Appalachian Regional Hospital, Beckley, WV, 25801, USA

Abstract: Colon cancer is one of the most common causes of cancer-related mortality. Adenocarcinoma with mucinous features accounts for 10–15% of colon carcinoma. Distal nodal metastatic colorectal cancer is uncommon, and metastasis of colorectal cancer to the left supraclavicular lymph node is extremely rare without signs of metastatic organ involvement. We present a case of a 54-year-old Caucasian male with colonic adenocarcinoma that presented initially as a left-sided neck mass that had progressively increased in size over 9 months. On physical exam, a left supraclavicular soft tissue mass 6 cm in diameter was appreciated, it was non-tender with no submandibular lymphadenopathy. Soft tissue mass was palpable on the anterior abdominal wall in the epigastric region. Open excisional tissue biopsy of the left supraclavicular mass revealed metastatic adenocarcinoma with mucinous features and colonoscopy revealed a 6 cm obstructing mass in the transverse colon with biopsy revealing primary adenocarcinoma of the mucinous type. Palliative care with comfort measures was agreed upon. Typically, the most common sites of colon cancer metastasis are regional lymph nodes, liver, lung, bone and brain, and ours demonstrated an extremely rare pattern of colon cancer metastasis. The presentation to metastasize to the left supraclavicular node without solid end organ involvement makes this case even more novel.

Keywords: Virchow’s node, adenocarcinoma with mucinous features from the colon, skip micrometastases, colon cancer, case report

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