Metastasis of nasopharyngeal carcinoma to parotid lymph nodes: a retrospective study

Suzhan Zhang,Jianlin Lou,Minghua Ge,Kejing Wang,Shengye Wang,Liang Guo

doi:10.1186/1477-7819-13-1

Abstract

BackgroundMalignant parotid tumors are rare metastases originating from nasopharyngeal carcinoma (NPC). This study aimed to investigate the clinicopathological features and outcome of patients with metastasis of NPC to parotid lymph nodes after surgical therapy.MethodsWe enrolled 14 NPC patients who had metastatic disease to parotid lymph nodes after IMRT. They received surgical treatment by total parotidectomy with neck dissection, superficial parotidectomy with neck dissection, partial parotidectomy with neck dissection, total parotidectomy, or superficial parotidectomy. Their age, gender, histopathology, clinical findings, and treatment outcome were analyzed.ResultsAfter radiotherapy, parotid metastasis represented as uncontrolled disease in three cases and as recurrent disease in 11 cases. All the 14 patients received salvaged surgery successfully. Pathologic findings showed grade 3 in most patients. The follow-up ranged from 11 to 120 months and the overall three- and five-year survival was 49.5% and 37.1%, respectively.ConclusionsMetastasis to parotid lymph nodes should be examined in NPC patients after IMRT. Resection of the inferior parotid lymph nodes is recommended for patients with cervical metastasis, and superficial or total parotidectomy and adjuvant therapy are recommended for intraparotid lymph node metastasis.

Highlights

Malignant parotid tumors are rare metastases originating from nasopharyngeal carcinoma (NPC)
Nasopharyngeal carcinoma (NPC) has a high incidence in China, especially in the southeast.Malignant parotid tumors are rare metastases originating from NPC
A total of three patients were identified as uncontrolled disease of parotid metastasis because lesions recurred within three months after the initial treatment of radiotherapy

Summary

Introduction

Malignant parotid tumors are rare metastases originating from nasopharyngeal carcinoma (NPC). This study aimed to investigate the clinicopathological features and outcome of patients with metastasis of NPC to parotid lymph nodes after surgical therapy. A quarter of malignant parotid tumors are metastases originating from head and neck tumors such as scalp, face, eyelid, oral cavity, and oropharynx. Squamous cell carcinoma (SCC) and malignant melanoma are the most common [1,2,3]. Nasopharyngeal carcinoma (NPC) has a high incidence in China, especially in the southeast.Malignant parotid tumors are rare metastases originating from NPC. Radiotherapy is the most standardized method for NPC and the conventional dose of radiotherapy is between 60 and 70 Gy. The parotid space harbors three groups of lymph nodes determined by the embryological development of the parotid gland.

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