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Cutaneous squamous cell carcinoma of the head and neck metastasizing to the parotid gland—A review of current recommendations

✍ Scribed by James O'Hara; Alfio Ferlito; Robert P. Takes; Alessandra Rinaldo; Primož Strojan; Ashok R. Shaha; Juan P. Rodrigo; Vinidh Paleri

Publisher: John Wiley and Sons
Year: 2010
Tongue: English
Weight: 97 KB
Volume: 33
Category: Article
ISSN: 1043-3074
DOI: 10.1002/hed.21583

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✦ Synopsis

Abstract

Cutaneous squamous cell carcinoma (SCC) of the head and neck may metastasize in up to 5% of patients, with the parotid lymph nodes the most frequent site for spread. Metastases frequently show delayed presentation after the primary cancer had been treated. The optimum treatment should be surgery followed by adjuvant radiotherapy, with an appropriate parotidectomy, and preservation of the facial nerve if not involved by tumor and treatment to the neck. In a clinically N0 neck, levels I to III should be cleared for facial primaries, levels II to III for anterior scalp and external ear primaries, and levels II to V for posterior scalp primaries. Approximate 5‐year disease‐specific survival (DSS) after treatment was 70% to 75%. Patients with immunosuppression, in particular transplant recipients, are at high risk of developing aggressive metastatic cutaneous SCC. Modifications of the staging systems have demonstrated the prognostic benefits of accurately staging parotid and/or neck nodal disease. © 2010 Wiley Periodicals, Inc. Head Neck, 2010

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