Transoesophageal endoscopic-ultrasonography-guided 125I permanent brachytherapy for unresectable mediastinal lymphadenopathy.

A 59-year-old woman with an isolated nodal relapse of adenocarcinoma of the lung was referred to our institution for salvage therapy after lobectomy, adjuvant chemotherapy, and thoracic radiotherapy. Her oncological medical history dated back to November, 2001, when a solitary lung mass was found in the left upper lobe during routine chest radiography.

Subsequent bronchoscopy showed a lesion in the left upper bronchus, and the subsequent biopsy was positive for adenocarcinoma of the lung. Work-up studies were negative for regional lymphadenopathy or metastatic disease (clinical stage T1N0M0).

The patient underwent a left-upper lobectomy with mediastinal lymphadenectomy on March 6, 2002. The final pathology report confirmed the diagnosis of adenocarcinoma of the lung (maximum diameter 2 cm) with no other remarkable pathological features. Two of eight lymph nodes resected at the level of the aortopulmonary window (nodal station 5) were positive for adenocarcinoma (pathological stage T1N2M0). An 18-fluorodeoxyglucose ([¹⁸F]FDG)-PET scan done after surgery was positive for residual disease in the mediastinum.

CITATION Lancet Oncol. 2006 Sep;7(9):781-3