title: Dominant lymph drainage patterns in the occipital and parietal regions: evaluation of lymph nodes in patients with skin cancer of the head.
abstract: BACKGROUND
  The purpose of this study was to evaluate the superficial lymph drainage patterns of primary skin cancers of the head arising from the occipital or parietal region.
  
  
  METHODS
  The dominant patterns of lymph drainage were retrospectively reviewed in eight patients aged 36-85 years with skin cancers in the occipital or parietal region in whom sentinel lymph node biopsy or lymph node dissection had been performed at Hokkaido University Hospital between January 1981 and December 2015.
  
  
  RESULTS
  Lymph drainage was mainly to the occipital (6/8, 75%), level II (5/8, 63%), and level V lymph nodes (5/8, 63%). Of the six patients with drainage to the occipital lymph nodes, four (67%) also had drainage to level V nodes.
  
  
  CONCLUSIONS
  The dominant lymph drainage pattern in patients with skin cancer arising from the occipital or parietal region was to the occipital, level II, and level V lymph nodes. Further, lymph tended to drain directly from the occipital region to the level V lymph nodes.
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo City, Hokkaido, 060-8638, Japan.
authors.forename: Taku
authors.initials: T
authors.lastname: Maeda
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo City, Hokkaido, 060-8638, Japan.
authors.forename: Yuhei
authors.initials: Y
authors.lastname: Yamamoto
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo City, Hokkaido, 060-8638, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Furukawa
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo City, Hokkaido, 060-8638, Japan.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Oyama
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo City, Hokkaido, 060-8638, Japan.
authors.forename: Emi
authors.initials: E
authors.lastname: Funayama
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo City, Hokkaido, 060-8638, Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Murao
authors.affiliation: Department of Plastic and Reconstructive Surgery, Graduate School of Medicine, Hokkaido University, Kita-15 Nishi-7, Kita-ku, Sapporo City, Hokkaido, 060-8638, Japan. toshi-116@nifty.com.|Department of Oral and Maxillofacial Surgery, Graduate School of Dental Medicine, Hokkaido University, Sapporo City, Hokkaido, Japan. toshi-116@nifty.com.
authors.forename: Toshihiko
authors.identifier: http://orcid.org/0000-0002-1180-1685
authors.initials: T
authors.lastname: Hayashi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006258:Head and Neck Neoplasms / Q000473:pathology*; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology*; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008545:Melanoma / Q000473:pathology; D008875:Middle Aged; D009778:Occipital Lobe / Q000473:pathology; D010296:Parietal Lobe / Q000473:pathology*; D012189:Retrospective Studies; D021701:Sentinel Lymph Node Biopsy; D012878:Skin Neoplasms / Q000473:pathology*
keywords: Lymph node dissection; Lymphatic flow; Parieto-occipital region; Sentinel lymph node; Skin cancer