Successful Treatment of Synchronous Solitary Ipsilateral Axillary Lymph Node Metastasis from Non-Small Cell Lung Cancer with Radical Resection and Perioperative Chemotherapy

Lung cancer is the leading cause of death from cancer worldwide. Almost 60% of patients with non-small cell lung cancer present with metastasis at the time of diagnosis. Without treatment, the median survival for patients with metastatic non-small cell lung cancer is only 3-4 months. While targeted therapy has improved median overall survival to 12 months and even longer in patients with driver mutations, most patients with initial response to targeted agents ultimately develop disease progression. On the other hand, several studies have shown resection of solitary brain or adrenal metastases may achieve long-term survival in selected patients. However, in patients with solitary extra-cranial, extra-adrenal metastases, the results of metastasectomy have rarely been reported. Herein, we report a case of synchronous solitary axillary lymph node metastasis from non-small cell lung cancer. Surgical resection of both the primary lung tumor and metastasis combined with perioperative chemotherapy achieved prolonged disease- free survival in this case. To date, the optimal treatment strategy for patients with solitary distant lymph node metastases and resectable primary lung tumors has not been established. The addition of metastasectomy to primary lung cancer surgery may provide a chance for long-term survival for such patients.