When neck lymph nodes metastases do not origin from a head and neck unknown primary

Area of Science:

• Oncology
• Head and Neck Surgery
• Diagnostic Imaging

Background:

• Cervical metastasis from distant primary tumors presents diagnostic and therapeutic challenges.
• Limited evidence exists for standardized management protocols.
• Multidisciplinary team input is crucial for complex cases.

Purpose of the Study:

• To review the current research status on cervical metastasis from distant primary tumors.
• To present the latest diagnostic and therapeutic approaches.
• To highlight the importance of a standardized management strategy.

Main Methods:

• Literature review of current research on cervical metastasis.
• Analysis of diagnostic tools including imaging, immunohistochemistry, next-generation sequencing, and AI.
• Evaluation of therapeutic interventions such as neck dissection and adjuvant chemoradiotherapy.

Main Results:

• Metastasis can affect all neck levels, often levels IV and V for infraclavicular tumors.
• Next-generation sequencing and AI show promise for primary tumor identification.
• Neck dissection with adjuvant chemoradiotherapy improves survival in select cancers (breast, lung, renal, esophageal, testicular).

Conclusions:

• Diagnosis and treatment require a multidisciplinary approach.
• Isolated supraclavicular metastases warrant investigation for a distant primary.
• Surgical treatment of the neck may improve prognosis in specific cases; primary tumor control is essential.