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Journal of Stomatology Oral and Maxillofacial Surgery
Volume 120, n° 2
pages 160-163 (avril 2019)
Doi : 10.1016/j.jormas.2018.10.010
Received : 22 May 2018 ;  accepted : 21 October 2018
Case Reports

Axillary lymph node metastasis in second oropharyngeal cancer
 

S. Alessandro a, , M. Magremanne a, E. Marbaix b, H. Reychler a, P. Mahy a
a Service de stomatologie et chirurgie maxillo-faciale, Cliniques universitaires Saint-Luc, UCL, avenue Hippocrate 10, 1200 Bruxelles, Belgium 
b Service d’anatomie pathologique, Cliniques universitaires Saint-Luc, UCL, avenue Hippocrate 10, 1200 Bruxelles, Belgium 

Corresponding author.
Abstract
Background

The risk of metastasizing in axillary lymph node is occasional in the head and neck cancers. This pattern of spread is difficult to explain and totally unpredictable even for these lymphophilic cancers.

Observation

A 72-year-old patient benefited, 11 years ago, of surgical oncology care associated with adjuvant radiotherapy for squamous cell carcinoma of the left floor of the mouth (pT4 pN2b M0). He presented a second primary malignancy at the right oropharyngeal level. Pet CT revealed a right infraclinic axillary metastasis. The metastatic origin was confirmed by pathological analysis.

Discussion

The current management of head and neck cancers is based on the histological pattern of infiltration, the size of the primary tumor and the pattern of metastasizing lymph nodes and potential distant spreading. Current tests allow us to diagnose most distant metastases even outside the usual area of lymphatic drainage. Involvement of axillary lymph node, probably through retrograde lymphatic spreading is not so rare in recurrences of oropharyngeal cancer (T3–T4, N2…) as we have observed in the literature. In this review, we raise some degree of similarity between such oncological progression and factors related to this aberrant spreading.

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Keywords : Neoplasm metastasis, Axilla, Lymph node, Squamous cell carcinoma




© 2018  Published by Elsevier Masson SAS.