title: Pleural Metastasis in Head and Neck Cancer: Imaging Findings and Clinical Impact.
abstract: OBJECTIVE
  The aim of this study was to present the imaging findings of pleural metastases from head and neck cancer and correlate them with prognosis for overall survival, which to our knowledge have not received much attention in radiology literature.
  
  
  METHODS
  We reviewed 23 cases of head and neck cancer with pleural metastases that were seen on head and neck imaging. Computed tomography (CT), magnetic resonance imaging, and positron emission tomography/CT imaging findings were reviewed. The location and cell type of the primary cancer were studied. The effect of the pleural metastases on patient survival was analyzed.
  
  
  RESULTS
  Twelve (57%) of the 21 cases of pleural metastasis were missed initially on the neck CT but were visible in retrospect. Nine of 11 patients whom we had followed up for 1.5 years or longer have died, often within a few of months of presenting with pleural metastases.
  
  
  CONCLUSIONS
  The presence of pleural metastasis in head and neck cancer is an extremely poor prognostic indicator for survival. They are potentially missed on the neck CT. Given its significant clinical impact, head and neck radiologists should specifically look for pleural metastasis when reviewing imaging studies of patients with head and neck cancer.
authors.affiliation: From the Department of Diagnostic Radiology, University of Texas MD Anderson Cancer Center, Houston, TX.
authors.forename: Bing
authors.initials: B
authors.lastname: Wang
authors.forename: Sonia Betancourt
authors.initials: SB
authors.lastname: Cuellar
authors.forename: Lawrence E
authors.initials: LE
authors.lastname: Ginsberg
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D008875:Middle Aged; D010994:Pleura / Q000000981:diagnostic imaging; D010997:Pleural Neoplasms / Q000000981:diagnostic imaging* / Q000556:secondary*; D000072078:Positron Emission Tomography Computed Tomography / Q000379:methods; D011379:Prognosis; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods; D055815:Young Adult