A patient presents with enlarged right supraclavicular (Virchow's) lymph node. Which of the following primary tumours is MOST likely to metastasize to this node via the thoracic duct?

• A Right breast carcinoma
• B Right lung carcinoma
• C Head and neck squamous carcinoma
• D Gastric carcinoma ✓

Explanation

Troisier's sign (enlarged left supraclavicular/Virchow's node) is classically associated with abdominal malignancies (gastric carcinoma, pancreatic, ovarian) because the thoracic duct drains abdominal lymph and empties into the left subclavian vein near the left supraclavicular fossa. Right supraclavicular node enlargement is more typical of thoracic (right lung, oesophagus) or head/neck primaries draining via the right lymphatic duct. However, among the given options, gastric carcinoma via the thoracic duct pathway is the classic teaching answer.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.