Cervical lymph node metastases: oncologic imaging and diagnosis

Cervical metastatic disease is an issue of paramount importance in the diagnosis and management of head and neck malignancies. The frequency of cervical metastases from squamous cell carcinoma of the upper aerodigestive tract varies mainly with the site of the primary. In general, the presence of histologically confirmed metastases halves the five year survival for any given primary. With improvements in treatment and the resultant prolonged survival, the incidence of distant metastases from head and neck cancer has risen. The imaging of metastatic cervical neck nodes by CT has made a major impact on clinical assessment of nodal involvement. The treatment issues related to the presence and extent of cervical metastases will be discussed in light of the ability of CT scans to stage the neck.