Pattern of regional metastases from cutaneous squamous cell carcinoma of the head and neck

2005 ◽  
Vol 132 (6) ◽  
pp. 852-856 ◽  
Author(s):  
Geva Barzilai ◽  
Elhanan Greenberg ◽  
Raanan Cohen-Kerem ◽  
Ilana Doweck
Keyword(s):  
Parotid Gland ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Retrospective Chart Review ◽  
Academic Center ◽  
Level Ii ◽  
Regional Metastases ◽  
Neck Metastases ◽  
High Incidence ◽  
Occult Disease

OBJECTIVE: To assess the pattern of regional metastases from SCC of the skin of the head and neck as a prognostic factor. STUDY DESIGN AND SETTING: A retrospective chart review of 22 patients treated in a tertiary academic center. RESULTS: Metastases could be assessed clinically in the parotid gland and the neck in 50% and 59% of the patients, respectively. Histologic examination showed metastases in the parotid gland and the neck in 68% and 45.5%, respectively. Occult disease was 36% and 20% in the parotid gland and neck, respectively. The 1st echelon for metastasis was the parotid gland lymph nodes, whereas level II lymph nodes were the 1st echelon in the neck. Metastases to both the parotid gland and neck decreased the overall survival to 0, compared with 60% for metastases to the parotid gland and 100% for the neck. CONCLUSIONS: SCC of the skin of the head and neck with regional metastases has a high incidence of occult metastases in the parotid gland and the neck. Patients with metastases in both sites have a poor prognosis.

scholarly journals Guidelines for safe and optimum neck dissection: a review article

2021 ◽  
Author(s):  
Sheetal A. Murchite ◽  
Thakut Gowtham ◽  
Abhinandan Milind Kadiyal ◽  
Vaishali Vinayak Gaikwad ◽  
Ashutosh Tiwari
Keyword(s):  
Lymph Nodes ◽  
Head And Neck ◽  
Neck Dissection ◽  
Early Stage ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Regional Lymph Nodes ◽  
Cervical Lymph Nodes ◽  
Early Stage Disease ◽  
Regional Metastases

Head and neck cancer is the sixth most common cancer worldwide. The single most important factor affecting prognosis for squamous cell carcinoma is the status of the cervical lymph nodes. Metastasis to the regional lymph nodes reduces the 5-year survival rate by 50% compared with that of patients with early-stage disease. The American cancer society reports that 40% of patients with squamous carcinoma of the oral cavity and pharynx present with regional metastases to the cervical lymph nodes. This activity presents the steps for safe and optimum neck dissection. Objectives of the study were to identify the anatomical structures in neck dissection, review the complications of head and neck surgery and summarize the importance of care coordination and to improve outcomes for patients undergoing head and neck surgery.

scholarly journals An approach towards metastatic neck nodes and most common site of primaries: a retrospective study

2019 ◽  
Vol 5 (5) ◽  
pp. 1222
Author(s):  
Rudra Prakash ◽  
Smrity Rupa Borah Dutta
Keyword(s):  
Head And Neck Cancer ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Neck Cancer ◽  
Selective Neck Dissection ◽  
Neck Node ◽  
Cervical Lymph Nodes ◽  
N0 Neck ◽  
Level Ii ◽  
Total Cancer

<p class="abstract"><strong>Background:</strong> Head and neck cancer is one of the most common cancers in India and worldwide. It accounts for 30 percent of the total cancer burden. Head and neck cancers are notorious for loco regional spread presenting late with metastastasis to cervical lymph nodes.</p><p class="abstract"><strong>Methods:</strong> Our study was carried out on patients presenting with metastatic neck nodes at Silchar Medical College and Hospital, Assam from 1<sup>st</sup> April 2013 to 30<sup>th</sup> March 2015.  </p><p class="abstract"><strong>Results:</strong> In our study 167 patients presented with head and neck cancer with metastatic neck nodes. Metastatic nodes involving level II accounted for 51.4% of cases with primaries in oral cavity, base of tongue. Level III lymph nodes were involved in 48.6% of cases with primaries in the hypopharynx and larynx.</p><p><strong>Conclusions:</strong> In our study it was found that hypopharynx is the most common primary head and neck cancer with metastatic neck node. The most commonly involved lymph nodes are level II and level III. This helps in understanding the pattern of micrometastases in head and neck cancer patients with N0 neck which makes way for the role of selective neck dissection in these groups of patients.</p>

scholarly journals Nodal Metastases in Acinic Cell Carcinoma of the Parotid Gland

2019 ◽  
Vol 8 (9) ◽  
pp. 1315 ◽  
Author(s):  
Stefan Grasl ◽  
Stefan Janik ◽  
Matthaeus C. Grasl ◽  
Johannes Pammer ◽  
Michael Formanek ◽  
...  
Keyword(s):  
Parotid Gland ◽  
Cell Carcinoma ◽  
Disease Free Survival ◽  
Retrospective Chart Review ◽  
Acinic Cell Carcinoma ◽  
Elective Neck Dissection ◽  
Low Grade ◽  
Acinic Cell ◽  
Neck Metastases ◽  
High Grade Carcinoma

The objective of this study was to evaluate the clinical outcome of patients with acinic cell carcinomas of the parotid gland after elective neck dissection (END). A retrospective chart review was performed including 66 patients with acinic cell carcinoma of the parotid gland. Clinical parameters were retrieved and statistically analyzed regarding disease-free survival (DFS) and disease-specific survival (DSS). An END was done in 27 (40.9%) patients, and occult metastases were detected in 4 (14.8%) patients of whom three were low-grade carcinoma. Positive neck nodes were associated with significantly worse DSS (p = 0.05). Intermediate and high-grade carcinoma (HR 8.62; 95% confidence interval (CI): 1.69–44.01; p = 0.010), perineural invasion (HR 19.6; 95%CI: 0.01–0.37; p = 0.003) and lymphovascular invasion (HR 10.2; 95%CI: 0.02–0.59; p = 0.011) were worse prognostic factors for DFS. An END should be considered in patients with acinic cell carcinoma of the parotid gland due to (i) a notable rate of occult neck metastases in low-grade tumors and (ii) the worse DSS of patients with positive neck nodes.

Value of SPECT/CT for Sentinel Lymph Node Localization in the Parotid and External Jugular Chain

2018 ◽  
Vol 159 (5) ◽  
pp. 866-870
Author(s):  
Rosh K.V. Sethi ◽  
Nicholas B. Abt ◽  
Aaron Remenschneider ◽  
Yingbing Wang ◽  
Kevin S. Emerick
Keyword(s):  
Computed Tomography ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Predictive Value ◽  
Ct Imaging ◽  
Sternocleidomastoid Muscle ◽  
Head And Neck Malignancy ◽  
Level Ii ◽  
Neck Malignancy ◽  
Sensitivity Specificity

Objective Preoperative single-photon emission computed tomography/computed tomography (SPECT/CT) imaging may aid in the localization of sentinel lymph nodes (SLNs) in cutaneous head and neck malignancy and has been rigorously evaluated for deep cervical lymph nodes. The purpose of this study was to assess the sensitivity, specificity, and positive predictive value (PPV) of SPECT/CT for preoperative localization of nodal basins superficial to the sternocleidomastoid muscle, with comparison to deep nodal basins of the neck. Study Design Retrospective review. Setting Tertiary care center. Subjects and Methods SPECT/CT images obtained preoperatively for patients undergoing SLN biopsy for cutaneous head and neck malignancy between June 2015 and June 2016 were reviewed by a blinded nuclear medicine physician and head and neck surgeon. SPECT/CT imaging was compared to intraoperatively determined SLN location via gamma probe. Sensitivity, specificity, and positive and negative predictive values were determined and compared for superficial (external jugular [EJ] and parotid) nodes vs level II nodes. Results Fifty-three patients were included in the study. Most had cutaneous melanoma (69.8%). The PPV of EJ/parotid node identification by SPECT/CT imaging was 85.7%, specificity was 88.9%, and sensitivity was 69.2%. Comparatively, the PPV for level II nodes was 76.9%, specificity was 50%, and sensitivity was 85.7%. No significant difference in SPECT/CT predictive value was identified between EJ/parotid and level II node identification ( P > .05). Conclusion SPECT/CT imaging has strong specificity and positive predictability for preoperative localization of SLN superficial to the sternocleidomastoid muscle in cutaneous head and neck malignancy. SPECT/CT imaging may be a useful radiographic aid for preoperative SLN mapping in this patient population.

A PECULIAR CASE OF ISOLATED METASTATIC INGUINAL LYMPHADENOPATHY IN A YOUNG LADY – A CASE REPORT

2021 ◽  
pp. 59-60
Author(s):  
Anil Kumar MS ◽  
Pankaja SS ◽  
Kavuru Pavan Rajesh
Keyword(s):  
Lymph Nodes ◽  
Head And Neck ◽  
Fungal Infections ◽  
Nasopharyngeal Cancer ◽  
Concurrent Chemotherapy ◽  
Young Lady ◽  
Pelvic Malignancies ◽  
Regional Metastases ◽  
Inguinal Lymphadenopathy ◽  
Peculiar Case

Lymphadenopathy refers to the swelling of lymph nodes which can be secondary to bacterial, viral or fungal infections, autoimmune disease and malignancy. Lymphadenopathy can be localized or diffuse. About 75% of most lymphadenopathies are localized, and about 50% of those occur in the head and neck regions . Inguinal lymphadenopathy (3) occurs at the groin region and most common causes include infections of leg or foot, STDs, non Hodgkin's lymphoma, tuberculosis and pelvic malignancies. One of the rare causes includes distant metastasis of nasopharyngeal carcinoma (NPC) which is present in our case. Nasopharyngeal cancer is an uncommon squamous cell carcinoma in the head and neck region, in most parts of the world. It has a high propensity for lymphatic spread and is known for regional metastases with occult primary at presentation . The incidence of distant (1) metastasis at presentation ranges from 4.4 to 6%. The most common sites of metastasis are bone (70%–80%) followed by liver (30%), lungs (18%) and distant lymph nodes (axillary, mediastinal, pelvic and inguinal, in that order) . About 98% of them are discovered within 3 (2) years of treatment. As it is a highly chemo and radio-sensitive tumor, radiotherapy with concurrent chemotherapy is the mainstay in the management of local and advanced diseases. Here we are presenting a peculiar case of previously treated NPC presenting as isolated left inguinal metastatic lymphadenopathy in a young lady

scholarly journals Regional metastases of lower lip squamous cell carcinoma

2003 ◽  
Vol 56 (7-8) ◽  
pp. 322-325
Author(s):  
Miroslav Ilic ◽  
Asen Dzolev ◽  
Aleksandar Kiralj
Keyword(s):  
Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Squamous Cell ◽  
First Year ◽  
Lower Lip ◽  
Regional Metastases ◽  
Neck Metastases ◽  
Primary Neoplasm ◽  
Lip Carcinoma

Introduction Lower lip squamous cell carcinoma is the most common oral carcinoma. In relation to other oral carcinomas, it has a better clinical course. If regional metastases appear, lower lip carcinoma has a very poor prognosis. Methods This study included patients treated for lower lip squamous cell carcinoma in the period 1984-2001. We examined neck metastases and time of their appearance after operation of the primary neoplasm. Results Our retrospective study included 305 patients with lower lip carcinoma in a twelve-year period. Out of this number, 293 had no positive neck lymph nodes, and only 12 patients had (4%). More than 75% of metastases appeared in the first year after surgery of the primary neoplasm. Contralateral metastases were most common. Conclusion Taking into consideration the percentage of metastases, particularly during the first year after surgery, we suggest identification of sentinel lymph nodes and depending on PH finding one should decide about the type of neck operation. Frequent check-ups are necessary, especially during the first year.

Parotid Gland and its Lymph Nodes as Metastatic Sites

1983 ◽  
Vol 92 (2) ◽  
pp. 209-210 ◽  
Author(s):  
John G. Batsakis
Keyword(s):  
Parotid Gland ◽  
Lymph Nodes ◽  
Head And Neck ◽  
Squamous Cell ◽  
Squamous Cell Carcinomas ◽  
Upper Aerodigestive Tract ◽  
Mucous Membranes ◽  
Primary Neoplasms ◽  
Metastatic Sites ◽  
A Site

The parotid gland and its lymph nodes can serve as metastatic sites from regional and distant primary neoplasms. In the head and neck, the regions and neoplasms at risk for such metastases are melanomas and squamous cell carcinomas of the skin of the eyelids, frontal, temporal, posterior cheek and anterior ear regions. The mucous membranes of the upper aerodigestive tract may also be a site for a primary demonstrating parotid area metastases.

scholarly journals Eliminating radiotherapy to the contralateral retropharyngeal and high level II lymph nodes in head and neck squamous cell carcinoma is safe and improves quality of life

Cancer ◽  
2014 ◽  
Vol 120 (24) ◽  
pp. 3994-4002 ◽  
Author(s):  
Christopher R. Spencer ◽  
Hiram A. Gay ◽  
Bruce H. Haughey ◽  
Brian Nussenbaum ◽  
Douglas R. Adkins ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Squamous Cell Carcinoma ◽  
Lymph Nodes ◽  
Cell Carcinoma ◽  
Head And Neck ◽  
Squamous Cell ◽  
Neck Squamous Cell Carcinoma ◽  
Level Ii ◽  
High Level

scholarly journals Molecular Tumor Subtypes of HPV-Positive Head and Neck Cancers: Biological Characteristics and Implications for Clinical Outcomes

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2721
Author(s):  
Tingting Qin ◽  
Shiting Li ◽  
Leanne E. Henry ◽  
Siyu Liu ◽  
Maureen A. Sartor
Keyword(s):  
Head And Neck ◽  
Stromal Cells ◽  
Clinical Characteristics ◽  
Molecular Subtypes ◽  
Squamous Cell Carcinomas ◽  
Head And Neck Cancers ◽  
Molecular Signatures ◽  
Tumor Subtypes ◽  
Mesenchymal Differentiation ◽  
High Incidence

Until recently, research on the molecular signatures of Human papillomavirus (HPV)-associated head and neck cancers mainly focused on their differences with respect to HPV-negative head and neck squamous cell carcinomas (HNSCCs). However, given the continuing high incidence level of HPV-related HNSCC, the time is ripe to characterize the heterogeneity that exists within these cancers. Here, we review research thus far on HPV-positive HNSCC molecular subtypes, and their relationship with clinical characteristics and HPV integration into the host genome. Different omics data including host transcriptomics and epigenomics, as well as HPV characteristics, can provide complementary viewpoints. Keratinization, mesenchymal differentiation, immune signatures, stromal cells and oxidoreductive processes all play important roles.

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