title: Cervical lymph node metastases from remote primary tumor sites.
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. © 2015 Wiley Periodicals, Inc. Head Neck 38: E2374-E2385, 2016.
authors.affiliation: Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.|University of Oviedo, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: López
authors.affiliation: Department of Otolaryngology, Hospital Universitario Central de Asturias, Oviedo, Spain.|University of Oviedo, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain.
authors.forename: Juan P
authors.initials: JP
authors.lastname: Rodrigo
authors.affiliation: Departments of Surgery and Otolaryngology, Head and Neck Surgery, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Carl E
authors.initials: CE
authors.lastname: Silver
authors.affiliation: Departments of Medicine (Oncology) and Otorhinolaryngology-Head & Neck Surgery, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York.
authors.forename: Missak
authors.initials: M
authors.lastname: Haigentz
authors.affiliation: Departments of Pathology, The Johns Hopkins University, Baltimore, Maryland.
authors.forename: Justin A
authors.initials: JA
authors.lastname: Bishop
authors.affiliation: Department of Radiation Oncology, Institute of Oncology, Ljubljana, Slovenia.
authors.forename: Primož
authors.initials: P
authors.lastname: Strojan
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Institut Gustave Roussy, Villejuif Cedex, France.|Laboratoire de Phonétique et de Phonologie, Sorbonne Nouvelle, Paris, France.
authors.forename: Dana M
authors.initials: DM
authors.lastname: Hartl
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Nottingham University Hospitals, Queens Medical Centre Campus, Nottingham, United Kingdom.
authors.forename: Patrick J
authors.initials: PJ
authors.lastname: Bradley
authors.affiliation: Department of Radiation Oncology, University of Florida, Gainesville, Florida.
authors.forename: William M
authors.initials: WM
authors.lastname: Mendenhall
authors.affiliation: University of Oviedo, Instituto Universitario de Oncología del Principado de Asturias, Oviedo, Spain.
authors.forename: Carlos
authors.initials: C
authors.lastname: Suárez
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands.
authors.forename: Robert P
authors.initials: RP
authors.lastname: Takes
authors.affiliation: Department of Head and Neck Surgery, Head and Neck Oncology Program, St Luc University Hospital and Cancer Center, Brussels, Belgium.
authors.forename: Marc
authors.initials: M
authors.lastname: Hamoir
authors.affiliation: Division of Otolaryngology-Head and Neck Surgery, Southern Illinois University School of Medicine, Springfield, Illinois.
authors.forename: K Thomas
authors.initials: KT
authors.lastname: Robbins
authors.affiliation: Head and Neck Service, Memorial Sloan-Kettering Cancer Center, New York, New York.
authors.forename: Ashok R
authors.initials: AR
authors.lastname: Shaha
authors.affiliation: Department of Otolaryngology, Head and Neck Surgery, Marburg, Germany.
authors.forename: Jochen A
authors.initials: JA
authors.lastname: Werner
authors.affiliation: University of Udine School of Medicine, Udine, Italy.
authors.forename: Alessandra
authors.initials: A
authors.lastname: Rinaldo
authors.affiliation: Coordinator of the International Head and Neck Scientific Group.
authors.forename: Alfio
authors.initials: A
authors.lastname: Ferlito
mesh_terms: D019788:Fluorodeoxyglucose F18; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008198:Lymph Nodes / Q000000981:diagnostic imaging / Q000473:pathology; D008207:Lymphatic Metastasis / Q000000981:diagnostic imaging*; D000072078:Positron Emission Tomography Computed Tomography; D019275:Radiopharmaceuticals
chemical_list: D019275:Radiopharmaceuticals; D019788:Fluorodeoxyglucose F18
keywords: cervical lymph node; diagnosis; neck dissection; non-head and neck cancer; unknown primary