Resection of Colon Cancer and Its Metastases to the Virchow Lymph nodes in a patient with Sarcoidosis

A 60-year-old woman with 15-year sarcoidosis duration presenting with a tumor in the left supraclavicu lar fossa was found in aspiration biopsy to have moderately differenciated adenocaricinoma. Further investi gation showed advanced transverse colon cancer with paraaortic (No.216) and thoracic lymph node swelling. Under diagnosis of advanced transverse colon cancer with metastasis to the paraaortic and Virchow's lymph nodes and bilateral hilar lymphadenopathy (BHL) due to sarcoidosis, we conducted right hemicolectomy with D4 lymphadenectomy and left neck lymph node dissection. The resected lymph nodes at No.222, No.216a2, and 216b1showed mixed cancer metastasis and sarcoidosis. The patient remains alive and well without recur rence 3 years and 11 months after surgery with peroral chemotherapy of carmofur (300mg/day). This good prognosis was due to both right hemicolectomy with D4 lymphadenectomy and left neck lymph node dissection and postoperative chemotherapy.