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Head Neck. 2016 Apr;38 Suppl 1:E2374-85. doi: 10.1002/hed.24344. Epub 2015 Dec 29.

Cervical lymph node metastases from remote primary tumor sites.

Author information

1
Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.
2
University of Oviedo, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain.
3
Departments of Surgery and Otolaryngology, Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
4
Departments of Medicine (Oncology) and Otorhinolaryngology-Head & Neck Surgery, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
5
Departments of Pathology, The Johns Hopkins University, Baltimore, Maryland.
6
Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
7
Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France.
8
Laboratoire de Phonétique et de Phonologie, Sorbonne Nouvelle, Paris, France.
9
Department of Otolaryngology-Head and Neck Surgery, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, United Kingdom.
10
Department of Radiation Oncology, University of Florida, Gainesville, Florida.
11
Department of Otolaryngology-Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
12
Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital and Cancer Center, Brussels, Belgium.
13
Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois.
14
Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
15
Department of Otolaryngology, Head and Neck Surgery, Marburg, Germany.
16
University of Udine School of Medicine, Udine, Italy.
17
Coordinator of the International Head and Neck Scientific Group.

Abstract

Although most malignant lymphadenopathy in the neck represent lymphomas or metastases from head and neck primary tumors, occasionally, metastatic disease from remote, usually infraclavicular, sites presents as cervical lymphadenopathy with or without an obvious primary tumor. In general, these tumors metastasize to supraclavicular lymph nodes, but occasionally may present at an isolated higher neck level. A search for the primary tumor includes information gained by histology, immunohistochemistry, and evaluation of molecular markers that may be unique to the primary tumor site. In addition, 18F-fluoro-2-deoxyglocose positron emission tomography combined with CT (FDG-PET/CT) has greatly improved the ability to detect the location of an unknown primary tumor, particularly when in a remote location. Although cervical metastatic disease from a remote primary site is often incurable, there are situations in which meaningful survival can be achieved with appropriate local treatment. Management is quite complex and requires a truly multidisciplinary approach.

KEYWORDS:

cervical lymph node; diagnosis; neck dissection; non-head and neck cancer; unknown primary

PMID:
26713674
PMCID:
PMC4991634
DOI:
10.1002/hed.24344
[Indexed for MEDLINE]
Free PMC Article

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