원발병소불명의 경부임파절 전이암

Cervical nodal metastasis of unknown origin

Metastasis to the lymph nodes of the head and neck is not an unusual occurrence. In most cases, the primaiy will be found, Occasionally, however, in approximately 5 per cent of cases, even the most exhaustive history and physical examination as well as special roentgenologic studies and even biopsies of all suspected sites will not disclose the primary tumor. Metastatic cervical malignancy with an unknown primary source is termed occult primary. The treatment of cervical lymph node metastases in patients with unknown primary lesions has long been controversial. But even though the primary lesion remained occult, definitive treatment to the cervical metastases was advocated and carried out. Treatment modality for metastatic cervical lymph nodes with an unknown primary tumor may be surgery, radiotherapy, chemotherapy, or a combination of the three. The selection is based on the histologic findings, site, and clinical stage of the cancer. We report a case of squamous cell carcinoma in the right submandibular lymph node. Even with thorough clinical and radiological examinations, it was not possible to find the primary in any other part of the body. The lesion was removed by radical neck dissection and there is no evidence of the primary and/or recurrence for 11 months.