Assessment of second tier lymph nodes in melanoma and implications for extent of elective neck dissection in metastatic cutaneous malignancy of the parotid

Sydney Ch'ng*, Audrey Pinna, Kim Ioannou, Karolina Juszczyk, Kerwin Shannon, Anthony Clifford, Roger Uren, Jonathan R. Clark

*Corresponding author for this work

Research output: Contribution to journalReview article

5 Citations (Scopus)

Abstract

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.

Original languageEnglish
Pages (from-to)205-208
Number of pages4
JournalHead and Neck
Volume35
Issue number2
DOIs
Publication statusPublished - Feb 2013
Externally publishedYes

Keywords

  • neck dissection
  • parotid
  • second tier

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