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A survey of metastatic central nervous system tumors to cervical lymph nodes

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Abstract

In the realm of head and neck diseases, one particularly common clinical presentation is that of the patient with a cervical mass. In children, neck masses often prove to be developmental cysts; in adults, the recent onset of a neck mass can signal a metastasis from a head and neck squamous carcinoma. Less often, both adults and children may present with cervical masses caused by either non-Hodgkin’s lymphoma or Hodgkin’s disease. There are, of course, less frequently encountered differential diagnostic possibilities; one of the most uncommon of all is the possibility of metastasis from an intracranial tumor. Intracranial tumors rarely give rise to cervical node metastases. The present review examines the published experience with 128 tumors that gave rise to cervical node metastases in both adult and in pediatric patients. While it is presumed that the blood–brain barrier blocks the spread of most tumors beyond the intracranial locale, this is speculative. Although many of the cervical node metastases reported here arose after craniotomy (and, presumably, after breaching of the blood–brain barrier), some arose in the absence of any preceding surgical procedure. Cervical node metastases may arise from glial tumors (including glioblastoma multiforme, in both adult and pediatric patients) and non-glial tumors (such as medulloblastoma in pediatric patients). The history of a previous intracranial lesion is often the key to correct diagnosis, since, without prompting, neither the pathologist nor the radiologist is likely to think of a cervical node metastasis from a brain tumor when assessing a cervical mass of unknown etiology.

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Authors and Affiliations

  1. Department of Surgical Sciences, ENT Clinic, University of Udine, Udine, Italy

    Vanni Mondin, Alfio Ferlito & Alessandra Rinaldo

  2. Department of Pathology, Allegiance Health, Jackson, MI, USA

    Kenneth O. Devaney

  3. Oral Pathology, School of Dental Sciences and Dental Hospital, University of Liverpool, Liverpool, UK

    Julia A. Woolgar

  4. Department of Surgical Sciences, ENT Clinic, Azienda Ospedaliero-Universitaria, Piazzale S. Maria della Misericordia, 33100, Udine, Italy

    Alfio Ferlito

Authors
  1. Vanni Mondin
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  2. Alfio Ferlito
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  3. Kenneth O. Devaney
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  4. Julia A. Woolgar
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  5. Alessandra Rinaldo
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Corresponding author

Correspondence to Alfio Ferlito.

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This paper was written by members and invitees of the International Head and Neck Scientific Group (http://www.IHNSG.com).

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Mondin, V., Ferlito, A., Devaney, K.O. et al. A survey of metastatic central nervous system tumors to cervical lymph nodes. Eur Arch Otorhinolaryngol 267, 1657–1666 (2010). https://doi.org/10.1007/s00405-010-1357-1

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  • DOI: https://doi.org/10.1007/s00405-010-1357-1

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