Metastasis of infradiaphragmatic tumors to the left supraclavicular lymph node is also reported to be rare. In contrast, second primary cancer at other sites, such as the intrahepatic bile duct, bladder, and prostate, is rare in patients with tongue carcinoma. In patients with tongue carcinoma, the second primary cancer most frequently occurs in the oropharynx, followed by the esophagus and larynx. reported that the risk of a second primary oral cancer was higher (standardized incidence ratio 16.25, 95% confidence interval 13.04–20.02) than that of nonoral second primary cancer (standardized incidence ratio 1.37, 95% confidence interval 1.29–1.45) in Korean patients with cancer in the oral cavity. found a second primary cancer in 10% of patients with oral squamous cell carcinoma in their cohort, while Min et al. Patients with oral squamous cell carcinoma and those with other types of head and neck cancer are at higher risk of second primary cancer than patients with cancers at most other sites. The accumulation of cases and the search for optimal therapeutic strategies remain important. However, when metastasis is detected in the left supraclavicular node in patients with head and neck carcinoma, locating the primary cancer remains a difficult and time-consuming challenge. Supraclavicular lymph node metastasis has been reported to be more common in patients with lung and breast tumors (18.7% and 18.6%, respectively). Since Virchow's time, the survival rates of cancer patients have improved because of dramatic research advances in the epidemiology of cancer and the development of screening technologies and treatment methods. Pathological diagnosis on the basis of immunohistochemistry and specific diagnosis methods such as radiological and serological assessments are important for providing rapid diagnosis and appropriate treatment. This patient underwent bilateral orchiectomy and adjuvant hormonal therapy and survived for 47 months after diagnosis of left supraclavicular node metastasis. Prostate-specific antigen levels and magnetic resonance imaging findings aided the diagnostic process. In the prostate carcinoma case, 18F‐fluorodeoxyglucose uptake was weak. He survived for 2 months after diagnosis of left supraclavicular lymph node metastasis. GATA3 staining aided in the diagnosis of urothelial bladder cancer with left supraclavicular node metastasis. Hematoxylin–eosin staining of the bladder lesion did not identify a clear glandular or squamous component, and we could not make a definitive diagnosis of whether the lesion was poorly differentiated squamous cell carcinoma, adenocarcinoma, or high-grade urothelial carcinoma. In the bladder carcinoma case, pathological analysis of fine-needle aspiration biopsy specimen of the metastatic cervical lymph node showed atypical cells with slight squamous differentiation. Palliative care only was given, with survival for 11 months after diagnosis of lymph node metastasis. In the cholangiocarcinoma case, carbohydrate antigen 19-9 and alpha-fetoprotein levels helped to diagnose cholangiocarcinoma. In these cases, adenocarcinoma was diagnosed based on left supraclavicular node biopsies, and a second primary tumor was found, in a 78-year-old Japanese woman with a diagnosis of cholangiocarcinoma, a 64-year-old Japanese man with a diagnosis of bladder carcinoma, and a 61-year-old Japanese man with a diagnosis of prostate carcinoma. We report three cases of malignant infradiaphragmatic tumor diagnosed following an initial finding of left supraclavicular node metastasis after surgery for tongue squamous cell carcinoma (follow-up period, range 18–62 months). When metastasis is detected in the left supraclavicular node in patients with head and neck carcinoma, locating the primary cancer remains a difficult and time-consuming challenge despite the dramatic development of screening technologies and treatment methods. Metastasis of infradiaphragmatic tumors to the left supraclavicular lymph node is reported to be rare.
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