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Updated: Aug 21, 2026
Modified Radical Neck Dissection for Cervical Metastasis
Published on: February 20, 2026
Unexpected findings in neck dissection for squamous cell carcinoma: incidence and implications
Patrick Sheahan1, Maky Hafidh, Mary Toner
1Department of Otolaryngology, St. James Hospital, 17 Hampton Square, Navan Road, Dublin 7, Ireland. sheahanp@eircom.net
Background:
During the pathologic examination of neck dissections, unexpected pathologic findings may occasionally be encountered. These pathologic findings may simulate malignant disease and/or have implications on the already complicated management of patients with head and neck cancer.
Methods:
We retrospectively reviewed 202 consecutive patients with a preoperative diagnosis of squamous cell carcinoma (SCC), who underwent 307 neck dissections performed by a single surgeon and examined by a single pathologist.
Results:
Ten patients had an unexpected finding. These included metastatic papillary thyroid carcinoma, leukemia, lymphoma, Warthin's tumor, and tuberculosis. Two of three patients with benign-appearing thyroid tissue within lymph nodes received no further treatment, and both remained well beyond 6 years. Four patients succumbed to SCC; none died from the incidentally discovered pathologic findings.
Conclusions:
Unexpected pathologic findings may be present in more than 3% of neck dissections. Although this is usually indolent, with the underlying SCC remaining the main prognostic determinate, it may significantly complicate postoperative management.
