Anatomical analysis of distant lymph node metastasis from cancer of the uterine cervix: a case report and literature review

Lymph node metastasis (LNM) beyond the pelvis and paraaortic region is unusual for the uterine cervix cancer (CC). The mechanism of these distant lymph node metastasis is not clearly understood. We reported a case of cervix cancer with extensive distant lymph node metastasis, including in the inguinal region, celiac region, mediastinal region, bilateral lower neck and supraclavicular regions. The literature was reviewed and possible anatomical mechanism was analyzed. Retrograde lymphatic drainage through many routes may explain these distant lymph node metastasis. Except the insufficient valves of lateral branches of thoracic duct, the blockage and compression of the lymphatic vessels or thoracic duct may be reasons for the retrograde lymphatic drainage. However, the lymphatics are complex and variable between individuals. Further studies need to confirm these results.

Cervical cancer; Lymph nodes; Recurrence; Anatomy; Rhemoradiotherapy.

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