Unexpected findings in neck dissection for squamous cell carcinoma: Incidence and implications

✍ Scribed by Patrick Sheahan; Maky Hafidh; Mary Toner; Conrad Timon

• Publisher: John Wiley and Sons
• Year: 2004
• Tongue: English
• Weight: 89 KB
• Volume: 27
• Category: Article
• ISSN: 1043-3074
• DOI: 10.1002/hed.20110

✦ Synopsis

Background:

During the pathologic examination of neck dissections, unexpected pathologic findings may occasionally be encountered. these pathologic findings may simulate malignant disease and/or have implications on the already complicated management of patients with head and neck cancer.

Methods:

We retrospectively reviewed 202 consecutive patients with a preoperative diagnosis of squamous cell carcinoma (scc), who underwent 307 neck dissections performed by a single surgeon and examined by a single pathologist.

Results:

Ten patients had an unexpected finding. these included metastatic papillary thyroid carcinoma, leukemia, lymphoma, warthin's tumor, and tuberculosis. two of three patients with benign-appearing thyroid tissue within lymph nodes received no further treatment, and both remained well beyond 6 years. four patients succumbed to scc; none died from the incidentally discovered pathologic findings.

Conclusions:

Unexpected pathologic findings may be present in more than 3% of neck dissections. although this is usually indolent, with the underlying scc remaining the main prognostic determinate, it may significantly complicate postoperative management.