The significance of metastasis to lymph nodes in the supraclavicular space secondary to cancer originating in the abdominal and thoracic viscera has long been of interest to surgeons and pathologists. Virchow1 in 1848 first recognized the necessity for a careful examination of the supraclavicular fossa in patients with abdominal tumors. In 1889, Troisier2 published a study of 27 primary abdominal tumors, the majority in the stomach, which had metastasized to supraclavicular nodes. The eponyms of Virchow's or Troisier's node have been popularly used to this day.
Invasion of the supraclavicular nodes by cancer originating within the abdominal or thoracic cavity may become apparent during the course of development of the primary tumor, or the signal node may appear as a terminal manifestation of generalized cancer, or in some remarkable instances the enlarged supraclavicular nodes may constitute the only clinical evidence of cancer, the primary site of which remains