Pattern of Metastases of Squamous Cell Carcinoma in Cervical Lymph Node In Patients With Occult Primary

Abstract

Introduction: Squamous cell carcinoma is the most common cancer of the upper aerodigestive tract, accounting for more than 90% of cancers. Its method of spread is through lymphatic channels, with a high propensity toward deposition in the regional lymph nodes. Objective: To determine the pattern of metastesis of squamous cell carcinoma in cervical lymph node in patients with occult primary. Methods: This was an observational cross sectional study which was carried out in the Dept. of ENT, Abdul Malek Ukil Medical College Hospital, Noakhali, Bangladesh from January 2017 to June-2019. A Total 31 patients were selected according to selection criteria and level of involved lymph node and nodal staging was determined by careful clinical examination, biopsy of all suspicious site, CT scan, MRI, USG and X-ray. Results: Thirty One patients with metastatic neck node in whom the primary tumour was not found despite of extensive diagnostic procedure were studied in this series. Patients distribution Male were 78% and female 22%. In this study majority of patients were within 40-80 years and most of patients were male. Unilateral neck node metastasis was found in 90.32% cases and bilateral in 09.68% cases. There is high incidence of unilateral metastatic neck node. Involved lymph node was found single in 54.83% and multiple in 45.17% cases in our study. Consistency of lymph nodes were found hard in 51.61%, firm to hard in 32.25% and firm in 16.12% cases in our study. In this study nodes were found less than 3 cm in 38.70% cases, 3-6 cm in 48.38% cases and more than 6 cm in 12.90% cases. While levelling of the lymph node was concerned, in this study the most commonly involved lymph node region was level-II (41.93%) followed by level-III (16.12%). In this study 38.70% cases were in stage N1, 48.38% in stage N2 and 12.90% in stage N3. Maximum lymph nodes were 3-6 cm in size. Conclusion: Metastetic squamous cell carcinoma in cervical lymph node of occult primary common in .........