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Assessment of second tier lymph nodes in melanoma and implications for extent of elective neck dissection in metastatic cutaneous malignancy of the parotid
Author(s) -
Ch'ng Sydney,
Pinna Audrey,
Ioannou Kim,
Juszczyk Karolina,
Shan Kerwin,
Clifford Anthony,
Uren Roger,
Clark Jonathan R.
Publication year - 2013
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/hed.22948
Subject(s) - medicine , neck dissection , malignancy , occult , lymph , cervical lymph nodes , lymph node , melanoma , radiology , parotid gland , metastasis , head and neck , dissection (medical) , cervical lymphadenopathy , surgery , pathology , cancer , disease , cancer research , alternative medicine
Background The parotid is the commonest site of cutaneous metastases in the head and neck. The role and extent of neck dissection in patients with parotid metastatic cutaneous malignancy remains controversial. Methods We reviewed the lymphoscintigraphy and single photon emission CT (SPECT) of patients with melanoma who had a sentinel node in the parotid to determine the second tier cervical lymph nodes. Results Levels II and III cervical nodes make up 82% of second tier lymph nodes for the parotid, and levels IV and V, 12% and 4%, respectively. Second tier lymph nodes isolated to levels I, IV, or V, bypassing levels II and III, occurred in only 2% of cases. Conclusion The risk of harboring occult metastasis in levels I, IV, and V when levels II and III are negative is low. Levels II and III neck dissection is likely to be an effective staging procedure in patients with isolated parotid metastases. © 2012 Wiley Periodicals, Inc. Head Neck, 2013