The usefulness of thoracoscopic mediastinal lymph node biopsy for appropriate diagnosis and treatment of mediastinal lymph node swelling following surgical treatment of urinary tract carcinoma: A report of two cases

In cases of mediastinal lymph node swelling following surgical treatment of urinary tract carcinoma (urothelial carcinoma and renal cell carcinoma), it is imperative that we consider the metastasis of the primary cancer. However, there are various differential diagnoses for mediastinal lymph node swelling. In many cases, we cannot make a precise diagnosis by images alone. We experienced two cases where thoracoscopic mediastinal lymph node biopsy was successfully used for making a precise diagnosis and providing proper treatmen.The first case enabled a diagnosis of metastasis of urothelial cancer and the second case enabled a diagnosis of primary mediastinal lung cancer (TO lung cancer). In both cases, we were able to get a partial response by administering the proper treatment. In particular, new drugs are emerging in the field of urological carcinoma, and these drugs have proved to be very effective. In cases of mediastinal lymph node swelling following surgical treatment of urinary tract carcinoma, we should make an appropriate use of thoracoscopic lymph node biopsy.