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Pathways for cervical metastasis in malignant neoplasms of the head and neck region
Author(s) -
Wang Yuan,
Ow Thomas J.,
Myers Jeffrey N.
Publication year - 2012
Publication title -
clinical anatomy
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.667
H-Index - 71
eISSN - 1098-2353
pISSN - 0897-3806
DOI - 10.1002/ca.21249
Subject(s) - medicine , lymphatic system , neck dissection , head and neck , metastasis , cervical lymph nodes , head and neck squamous cell carcinoma , melanoma , sentinel node , biopsy , dissection (medical) , lymph node , pathology , head and neck cancer , radiology , carcinoma , cancer , surgery , radiation therapy , cancer research , breast cancer
Abstract There have been significant changes in the evaluation and management of lymphatic metastases in the neck during the past several decades, and knowledge of the functional anatomy of the cervical lymphatics is fundamental to the clinical management of metastasis in this region. This review provides a comprehensive description of the cervical lymphatics and discusses how this knowledge is used in the modern management of the neck lymphatics in the setting of common cancers of the head and neck. The patterns of tumor spread can be delineated based on the well‐studied functional anatomy of the lymphatic networks in the cervical region. The characteristics and patterns of metastatic spread for two common cancers found in this region, squamous cell carcinoma and cutaneous malignant melanoma, are discussed in this review. Significant improvements in clinical care, namely, selective neck dissection and sentinel lymph node biopsy aided by lymphoscintigraphy, have been developed and are based upon detailed studies of the pathways of metastatic spread. These advances have significantly decreased the morbidity associated with the evaluation and treatment of metastatic disease to the neck. Clin. Anat. 25:54–71, 2012. © 2011 Wiley‐Liss, Inc.