Aortic and para-aortic lymph nodes - Erler Zimmer 3D anatomy Series MP2103

This dissection model highlighting aortic and para-aortic lymph nodes is part of the exclusive Monash 3D anatomy series, a comprehensive series of human dissections reproduced with ultra-high resolution color 3D printing.

Clinical History.

This was the case of a 75-year-old woman who presented with symptoms of disease recurrence and confirmed to have multiple metastases to chemo-resistant retroperitoneal lymph nodes five years after initial therapy for stage IIIc serous adenocarcinoma of the ovary. Positron emission tomography/computed tomography (PET/CT) revealed involvement of para-aortic and pelvic nodes. She died of liver complications before treatment options, such as radical lymphadenectomy, could be considered.

Pathology

The specimen consists of the abdominal aorta and common iliac arteries surrounded by a large number of extremely enlarged para-aortic lymph nodes of the iliac lymph nodes. Histopathological examination revealed high-grade metastatic adenocarcinoma in some of the resected lymph nodes.

Additional Information.

Occasionally, lymph node metastasis is the only component at the time of ovarian carcinoma recurrence. In this case, the metastatic lymph nodes predicted by PET/CT completely matched the actual metastatic lymph nodes. Ultrasound (US) could also have confirmed the presence of such large lymph nodes. PET/CT or ultrasound often fail to identify microscopic disease in histopathologically ascertained positive lymph nodes. Therefore, it is difficult to reliably rule out lymph node metastasis during surveillance after initial surgery for ovarian cancer.

In the context of recurrent ovarian disease, systematic dissection of the aortic and pelvic node would be considered appropriate in younger women without other evidence of metastatic disease. This is unlikely to be curative, but may produce a palliative effect with symptom control and allow the testing of new therapies if available.
Most commonly, pelvic and aortic lymph node sampling is part of the formal surgical staging of epithelial ovarian cancer at the time of initial surgical treatment. In addition, in women who initially present with advanced ovarian carcinoma, systematic debulking of enlarged retroperitoneal lymph nodes will be considered if this leads to complete debulking of the tumor.

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What advantages does the Monash University anatomical dissection collection offer over plastic models or plastinated human specimens?

• Each body replica has been carefully created from selected patient X-ray data or human cadaver specimens selected by a highly trained team of anatomists at the Monash University Center for Human Anatomy Education to illustrate a range of clinically important areas of anatomy with a quality and fidelity that cannot be achieved with conventional anatomical models-this is real anatomy, not stylized anatomy.
• Each body replica has been rigorously checked by a team of highly trained anatomists at the Center for Human Anatomy Education, Monash University, to ensure the anatomical accuracy of the final product.
• The body replicas are not real human tissue and therefore not subject to any barriers of transportation, import, or use in educational facilities that do not hold an anatomy license. The Monash 3D Anatomy dissection series avoids these and other ethical issues that are raised when dealing with plastinated human remains.