Carcinoma of unknown primary (CUP) is known to have a poor prognosis with limited treatment options. Here, we report a rare case of a patient who was diagnosed with CUP with perigastric lymph node metastasis. Our patient was a woman in her 60s who was admitted to another hospital with cholangitis. On computed tomography, a solitary swollen lymph node beside the cardia was seen. On follow up after a year and a half, the lymph node seemed to have increased in size, and the patient was referred to our hospital for further scrutiny. Endoscopic ultrasound-guided fine needle aspiration of the lymph node was performed and squamous cell carcinoma was detected histopathologically. Despite further examination, the primary site remained undetectable. Since there was no other metastatic site, a planned laparoscopic dissection of the perigastric metastatic lymph node was carried out successfully. At thirty months after surgery, there was no sign of any recurrence and the primary site still remained unknown.http://purl.org/coar/resource_type/c_650
