Open AccessIntraparotid lymph node metastasis from a nasal septal carcinoma: an unusual source of the unknown primary
Author(s) -
Andrew Williamson,
Matthew Haywood,
Zaid Awad
Publication year - 2020
Publication title -
bmj case reports
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.231
H-Index - 26
ISSN - 1757-790X
DOI - 10.1136/bcr-2019-232096
Subject(s) - medicine , chemoradiotherapy , lymph node , cervical lymph nodes , head and neck cancer , radiology , neck dissection , nasal septum , metastasis , nose , carcinoma , cancer , radiation therapy , pathology , surgery
Metastatic disease to the parotid lymph nodes typically occurs secondary to head and neck and cutaneous squamous cell carcinomas (SCC). Nasal septal SCC is an exceedingly rare primary cancer that rarely spreads to regional lymph nodes. A 39-year-old man presented with left-sided cervical lymphadenopathy and nasal polyposis. Initial assessment suggested that he may have a head and neck SCC of unknown origin with nodal deposits in close proximity to the parotid gland. Cross-sectional imaging did not reveal the primary source. After further review of imaging and examination under anaesthetic, the primary SCC was found on the left nasal septum. The patient ultimately required a type 1 craniofacial resection and adjuvant chemoradiotherapy to treat the disease. Thorough investigation of the 'unknown primary' SCC including cross-sectional imaging and endoscopic examination is essential for the diagnosis of rare and unusual primary SCCs. Nasal septal SCC can be successfully managed with combined modality treatment in the form of surgical resection and chemoradiotherapy.