title: Supraclavicular metastases from distant primaries: what is the role of the head and neck surgeon?
abstract: Suspicious malignant supraclavicular lymphadenopathy provides a challenge for diagnosis and treatment. The wide variety of primary tumours that metastasise to this region should alert the clinician to look beyond the head and neck, particularly if it is the only site in the neck with suspected disease. As metastatic spread to these nodes from primaries not in the head and neck often indicates wide spread disease, neck dissection is controversial. In this article we review the lymphatic anatomy and discuss the investigation of supraclavicular lymphadenopathy. We discuss the evidence for the management of the neck in patients with subclavicular primary cancers (excluding lymphoma and melanoma) and the role of neck dissection.
authors.affiliation: Department of Maxillofacial Surgery, Queen Alexandra Hospital, Portsmouth, UK. t_aldridge@hotmail.com
authors.forename: Tom
authors.initials: T
authors.lastname: Aldridge
authors.forename: Atul
authors.initials: A
authors.lastname: Kusanale
authors.forename: Serryth
authors.initials: S
authors.lastname: Colbert
authors.forename: Peter A
authors.initials: PA
authors.lastname: Brennan
mesh_terms: D001943:Breast Neoplasms / Q000175:diagnosis; D003937:Diagnosis, Differential; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000175:diagnosis; D006801:Humans; D008175:Lung Neoplasms / Q000175:diagnosis; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008208:Lymphatic System / Q000033:anatomy & histology; D009333:Neck / Q000473:pathology; D037981:Neck Dissection; D041742:Upper Gastrointestinal Tract / Q000473:pathology; D014565:Urogenital Neoplasms / Q000175:diagnosis