[Metastatic cervical adenopathies appearing as primary. A propos of 124 cases]

The authors are defining the significance of a metastatic neck node from an occult carcinoma and review all the necessary investigations including surgical neck exploration and frozen section to establish the diagnosis. In such a case a radical neck dissection is carried out without delay and postoperative radiotherapy is applied on the neck with special portals focused on the pharyngo-larynx area where any possible infraclinic tumor might be located. The occult primary may become clinically detectable after a variable time interval, this occurrence is rather rare and becomes exceptional when irradiation has been delivered on the neck after surgical exploration. A high incidence of distant metastases is noticed during the follow-up period. The long term prognosis of metastatic cervical lymph node is rather poor and depends in particular of the size of the involved node.