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Metastatic Lymph Nodes

Signs and Symptoms of Metastatic Lymph Nodes

Cancer in the neck presents in two ways: you or a doctor feels a lump in the neck, or review of an imaging study for an unrelated reason identifies a mass in the neck that warrants an evaluation. Also worth mentioning is that skin cancers might be picked up by a new or changing spot on the skin of your neck.

Patients with lymphoma are typically younger than most patients with head and neck cancer. They might have generalized symptoms in addition to the neck mass such as fevers, chills, night sweats, fatigue and weight loss. There may also be additional enlarged lymph nodes in the body.

However, you should not jump to any conclusions. If you have a neck lump, it does not mean you have cancer. A general doctor will look at you, take a history and assess your risk factors. He or she might even try a couple of weeks of treatment with some medicines or therapies. However, if the neck mass doesn’t go away after a couple of weeks, or if it keeps getting bigger, your doctor should probably get some more tests or refer you to a specialist.

References

1 Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. Patterns of cervical lymph node metastasis from squamous carcinomas of the upper aerodigestive tract. The American Journal of Surgery. 1990;160(4):405-409.

2 Patterns of Cervical Node Metastases From Squamous Carcinoma of the Larynx. Arch Otolaryngol Head Neck Surg. 1990;116(4):432-435.

3 Zhang MQ, El-Mofty SK, Dávila RM. Detection of human papillomavirus-related squamous cell carcinoma cytologically and by in situ hybridization in fine-needle aspiration biopsies of cervical metastasis: a tool for identifying the site of an occult head and neck primary. Cancer. 2008;114(2):118-23.

4 Morton DL, Wen DR, Foshag LJ, Essner R, Cochran A. Intraoperative lymphatic mapping and selective cervical lymphadenectomy for early-stage melanomas of the head and neck. J Clin Oncol. 1993;11:1751-1756.

5 Civantos FJ, Zitsch RP, Schuller DE, Agrawal A, Smith RB, Nason R, Petruzelli G, Gourin CG, Wong RJ, Ferris RL, El Naggar A, Ridge JA, Paniello RC, Owzar K, McCall L, Chepeha DB, Yarbrough WG, Myers JN. Sentinel lymph node biopsy accurately stages the regional lymph nodes for T1-T2 oral squamous cell carcinomas: results of a prospective multi-institutional trial. J Clin Oncol. 2010;28(8):1395-400.

6 Balaker AE, Abemayor E, Elashoff D, St. John MA. Cancer of unknown primary: does treatment modality make a difference? Laryngoscope.2012;122(6):1279-82. doi: 10.1002/lary.22424. Epub 2012 Apr 26.

7 Cooper, J. S., et al. (2004). "Postoperative Concurrent Radiotherapy and Chemotherapy for High-Risk Squamous-Cell Carcinoma of the Head and Neck." New England Journal of Medicine 350(19): 1937-1944.

8 Bernier, J., et al. (2004). "Postoperative irradiation with or without concomitant chemotherapy for locally advanced head and neck cancer." N Engl J Med 350(19): 1945-1952.

9 Doescher, J., et al. (2017). "[The 8th edition of the AJCC Cancer Staging Manual: Updates in otorhinolaryngology, head and neck surgery]." HNO 65(12): 956-961.

10 Cohen, E. E., LaMonte, S. J., Erb, N. L., Beckman, K. L., Sadeghi, N. , Hutcheson, K. A., Stubblefield, M. D., Abbott, D. M., Fisher, P. S., Stein, K. D., Lyman, G. H. and Pratt‐Chapman, M. L. (2016), American Cancer Society Head and Neck Cancer Survivorship Care Guideline. CA: A Cancer Journal for Clinicians, 66: 203-239. doi:10.3322/caac.21343 

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