Origin of cystic squamous cell carcinoma metastases in head and neck lymph nodes: Addition of EBV testing improves diagnostic accuracy

Švajdler, Marián; Kašpírková, Jana; Hadravský, Ladislav; Laco, Ján; Dubinský, P.; Straka, Ľubomír; Ondič, Ondřej; Michal, Michal; Skálová, Alena

doi:10.1016/j.prp.2016.03.002

Cited by 16 publications

(8 citation statements)

References 49 publications

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“…The prevailing histological finding in the current study in patients with malignancy was SCC histology (85%). The majority of primary tumors were located in Waldeyer's ring (8,16). According to the current results, primary carcinoma of the hypopharynx should be included in the search for a primary tumor.…”

Section: Discussionmentioning

confidence: 82%

Cystic Lateral Neck Lesions: Etiologic and Differential Diagnostic Significance in a Series of 133 Patients

Franzen

Günzel²,

Buchali

et al. 2019

Anticancer Res

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Background: Patients presenting with a cystic lateral neck lesion may present diagnostic challenges against a backdrop of varied non-malignant and malignant etiologies. Patients: A total of 133 consecutive cases who underwent cystic neck tumor removal were evaluated for etiology and diagnostic procedure in order to develop an algorithm for therapeutic efficiency. Results: In 92 of 133 cases, a non-malignant tumor was diagnosed. In 41 cases, malignant lymphadenopathy was found. In cases with malignancy, males (p=0.001) and the elderly (p=0.001) were affected more frequently. Primary tumors were discovered by pan-endoscopy before neck surgery or in a second panendoscopy (with tonsillectomy and mapping biopsies) in cases with histologically confirmed squamous cell carcinoma. During intraoperative frozen-section evaluation (40 cases), a total of 30 patients underwent neck dissection during the first neck operation. Conclusion: In patients older than 40 years who present with cystic neck lesions, we recommend pan-endoscopy and intraoperative frozen section in cases where malignancy is suspected in order to avoid secondary neck dissections and delays in therapy.A cystic lesion of the lateral neck is a relatively rare occurrence for an Ear, Nose and Throat (ENT) specialist. The majority of cases are interpreted as branchial cleft cysts that arise from the second branchial arch and become symptomatic in children and younger adults (1). On the other hand, there are a wide variety of neck mass etiologies including congenital, local or systemic inflammatory, benign and malignant causes (2). Cystic metastases may represent a unique entity with different etiological features such as a lack of exposure to risk factors and presentation in younger or female patients. Patient age may be an independent predictive factor for malignancy (2, 3). In this way, a cystic neck lesion may represent a cystic metastasis of squamous cell carcinoma (SCC) from the head and neck, particularly in human papillomavirus-related carcinoma of Waldeyer's ring (4). However, cystic metastases should be separated from central necrosis following rapid tumor growth (5). Branchial cleft cyst carcinoma has long been a subject of discussion (6,7).This study investigated the data of patients who were admitted to the ENT Department by an ENT practitioner and diagnosed with a "branchial cleft cyst" requiring surgical treatment. The objective of the present study was to evaluate the significance of a cystic cervical mass in relation to etiology, diagnostic procedure and an algorithm for increased therapeutic efficiency.

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Section: Discussionmentioning

confidence: 82%

Cystic Lateral Neck Lesions: Etiologic and Differential Diagnostic Significance in a Series of 133 Patients

Franzen

Günzel²,

Buchali

et al. 2019

Anticancer Res

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“…Most cases of cystic SCC metastasis in the upper neck nodes are associated with HPV-positive oropharyngeal primary cancer [ 23 ]. In the majority of CUP patients with cystic SCC lymph node metastasis of the HN region, occult primary cancers are localized in the oropharynx [ 24 ]. In our female patients, the biopsy of tonsils or base of the tongue did not show cancer.…”

Section: Discussionmentioning

confidence: 99%

“…Several studies [22][23][24] have discussed the association between oropharyngeal HNSCC and cystic neck node metastasis. Most cases of cystic SCC metastasis in the upper neck nodes are associated with HPV-positive oropharyngeal primary cancer [23].…”

Section: Case Reports In Oncologymentioning

confidence: 99%

Neck Node Squamous Cell Metastasis from Unknown Primary and Mutagen Sensitivity: A Case Series

Bukovszky,

Fodor,

Székely

et al. 2023

Case Rep Oncol

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Most of the neck node metastases from cancer of unknown primary (CUP) are squamous cell carcinomas (SCCs). The majority of which are human papillomavirus (HPV)-related, frequently show cystic morphology referring to Waldeyer’s ring origin. Here, we report four cases of neck node SCCs metastases from CUP. In our institute, 432 patients with head and neck (HN) SCC underwent pretreatment mutagen sensitivity (MS) assay between 1996 and 2006. Among them, 4 patients ≤50 years of age had metastatic cervical nodes from CUP. The primary treatment was cervical node dissection ± radiotherapy. All patients had elevated (>1.0 chromatid break/cell) MS. One male patient died of progressive neck metastasis within 3 years and the 3 female patients are still alive more than 15 years after initial treatment of HPV+ (two) or cystic (one) SCC. Two female patients developed second and third distant site metachronous primary cancers. HPV+ or cystic HNSCC from CUP with elevated MS indicates good outcome. Distant site metachronous cancers of different histologic origins cannot be explained by field cancerization. The clinical significance of elevated MS in neck node SCC metastasis from CUP requires further investigation.

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“…According to NCCN guidelines 36 , an adenocarcinoma, SCC, undifferentiated carcinoma, neuroendocrine carcinoma, in stage T0 associated with positive p16-HPV should be treated as an oropharyngeal cancer 37 , and if it is associated with positive EBV / positive EBER, it must be treated as a nasopharyngeal cancer 38 . In T0 head and neck CUP, positive p16-HPV, one can opt for ipsilateral or bilateral cervical lymph node dissection followed by radiotherapy or concurrent systemic therapy/radiotherapy or induction chemotherapy followed by radiotherapy or concurrent systemic therapy/radiotherapy.…”

Section: Principles Of Treatment For Squamous Cell Carcinomas Adenoca...mentioning

confidence: 99%

Head and neck cancers of unknown primary: A diagnostic and therapeutic challenge

Enache

Sarafoleanu

2023

Romanian Journal of Rhinology

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Head and neck cancers of unknown primary (CUP) represent up to 10% of all cancers located in the head and neck. True cancers of unknown primary, which remain of undetected primary origin after a correct clinical, imaging, surgical evaluation, have a reported frequency of between 1% and 2%. Cancers of unknown primary of the head and neck are a diagnostic challenge, considering that their main clinical manifestation is represented by the appearance of lymph node metastases in the cervical region. In general, the detection of cancers with an unknown starting point is late, difficult, with significant therapeutic failure. The diagnostic-therapeutic approach starts from the histopathological structure of the lymph node metastasis and continues with a correct and complete imaging evaluation. In this review are presented the diagnosis and therapeutic challenges and importance of head and neck cancers with unknown primary.

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Origin of cystic squamous cell carcinoma metastases in head and neck lymph nodes: Addition of EBV testing improves diagnostic accuracy

Cited by 16 publications

References 49 publications

Cystic Lateral Neck Lesions: Etiologic and Differential Diagnostic Significance in a Series of 133 Patients

Cystic Lateral Neck Lesions: Etiologic and Differential Diagnostic Significance in a Series of 133 Patients

Neck Node Squamous Cell Metastasis from Unknown Primary and Mutagen Sensitivity: A Case Series

Head and neck cancers of unknown primary: A diagnostic and therapeutic challenge

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