评估黑色素瘤的二级淋巴结及其对腮腺转移性皮肤恶性肿瘤选择性颈部清扫术范围的影响。
Assessment of second tier lymph nodes in melanoma and implications for extent of elective neck dissection in metastatic cutaneous malignancy of the parotid.
机构信息
The Sydney Head & Neck Cancer Institute, Royal Prince Alfred Hospital, Missenden Road, Camperdown, Sydney, New South Wales, Australia.
出版信息
Head Neck. 2013 Feb;35(2):205-8. doi: 10.1002/hed.22948. Epub 2012 Jan 31.
BACKGROUND
The parotid is the commonest site of cutaneous metastases in the head and neck. The role and extent of neck dissection in patients with parotid metastatic cutaneous malignancy remains controversial.
METHODS
We reviewed the lymphoscintigraphy and single photon emission CT (SPECT) of patients with melanoma who had a sentinel node in the parotid to determine the second tier cervical lymph nodes.
RESULTS
Levels II and III cervical nodes make up 82% of second tier lymph nodes for the parotid, and levels IV and V, 12% and 4%, respectively. Second tier lymph nodes isolated to levels I, IV, or V, bypassing levels II and III, occurred in only 2% of cases.
CONCLUSION
The risk of harboring occult metastasis in levels I, IV, and V when levels II and III are negative is low. Levels II and III neck dissection is likely to be an effective staging procedure in patients with isolated parotid metastases.
背景
腮腺是头颈部皮肤转移的最常见部位。在腮腺转移性皮肤恶性肿瘤患者中，颈部清扫术的作用和范围仍存在争议。
方法
我们回顾了腮腺中有前哨淋巴结的黑色素瘤患者的淋巴闪烁显像和单光子发射 CT（SPECT），以确定第二级颈淋巴结。
结果
颈Ⅱ、Ⅲ区淋巴结占腮腺第二级淋巴结的 82%，颈Ⅳ、Ⅴ区分别占 12%和 4%。仅 2%的病例存在孤立于Ⅰ、Ⅳ或Ⅴ区而绕过Ⅱ、Ⅲ区的第二级淋巴结。
结论
当Ⅱ、Ⅲ区阴性时，Ⅰ、Ⅳ和Ⅴ区隐匿性转移的风险较低。对于孤立性腮腺转移的患者，颈Ⅱ、Ⅲ区清扫术可能是一种有效的分期手术。
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