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Metastatic Disease of Parotid Nodes
Bronwyn E. Hamilton, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            • Diagnostic Checklist

              TERMINOLOGY

              • Definitions

                • Lymphangitic or hematogeneous tumor spread to intraparotid lymph nodes (systemic metastases)
                • Parotid and periparotid nodes = 1st-order nodal station for skin squamous cell carcinoma (SCCa) and melanoma from scalp, auricle, and face (regional metastatic disease)

              IMAGING

              • General Features

                • CT Findings

                  • MR Findings

                    • Ultrasonographic Findings

                      • Nuclear Medicine Findings

                        • Imaging Recommendations

                          DIFFERENTIAL DIAGNOSIS

                            PATHOLOGY

                            • General Features

                              • Gross Pathologic & Surgical Features

                                • Microscopic Features

                                  CLINICAL ISSUES

                                  • Presentation

                                    • Demographics

                                      • Natural History & Prognosis

                                        • Treatment

                                          DIAGNOSTIC CHECKLIST

                                          • Consider

                                            • Image Interpretation Pearls

                                              • Reporting Tips

                                                Selected References

                                                1. Chen MM et al: Prognostic factors for squamous cell cancer of the parotid gland: an analysis of 2104 patients. Head Neck. 37(1):1-7, 2015
                                                2. Pfisterer MJ et al: Squamous cell carcinoma of the parotid gland: a population-based analysis of 2545 cases. Am J Otolaryngol. 35(4):469-75, 2014
                                                3. Sandu I et al: Misleading appearance in cervical lymph node US diagnosis - a report on sarcoidosis, Warthin tumor and squamous cell carcinoma metastases. Med Ultrason. 16(2):182-5, 2014
                                                4. Udager AM et al: Metastatic renal cell carcinoma, clear cell type, of the parotid gland: a case report, review of literature, and proposed algorithmic approach to salivary gland clear cell neoplasms in fine-needle aspiration biopsies. Diagn Cytopathol. 42(11):974-83, 2014
                                                5. Mansour N et al: Evaluation of parotid gland lesions with standard ultrasound, color duplex sonography, sonoelastography, and acoustic radiation force impulse imaging - a pilot study. Ultraschall Med. 33(3):283-8, 2012
                                                6. Olsen SM et al: Oral cavity and oropharynx squamous cell carcinoma with metastasis to the parotid lymph nodes. Oral Oncol. 47(2):142-4, 2011
                                                7. Peiffer N et al: Patterns of regional metastasis in advanced stage cutaneous squamous cell carcinoma of the auricle. Otolaryngol Head Neck Surg. 144(1):36-42, 2011
                                                8. Sellinger M et al: Contralateral metastasis of parotid gland in advanced breast cancer with peripheral facial paralysis. Arch Gynecol Obstet. 284(6):1557-60, 2011
                                                9. Guzzo M et al: Major and minor salivary gland tumors. Crit Rev Oncol Hematol. 74(2):134-48, 2010
                                                10. Laco J et al: Tumor-to-tumor metastasis: Warthin tumor as a recipient of lung carcinoma and of renal carcinoma - Report of two cases. Pathol Res Pract. 206(7):458-62, 2010
                                                11. Turner SJ et al: Metastatic cutaneous squamous cell carcinoma of the external ear: a high-risk cutaneous subsite. J Laryngol Otol. 124(1):26-31, 2010
                                                12. Ulubas B et al: Small cell lung cancer diagnosed with metastasis in parotid gland. J Craniofac Surg. 21(3):781-3, 2010
                                                13. Wang Z et al: Myoepithelial carcinoma of the parotid gland metastatic to the kidney: case report and review of the literature. Diagn Cytopathol. 38(4):279-82, 2010
                                                14. Bangerter M: Cytomorphologic pitfall of primary malignant melanoma of the parotid gland: a case report. Acta Cytol. 53(4):435-6, 2009
                                                15. Dong XR et al: Parotid gland metastasis of nasopharyngeal carcinoma: case report and review of the literature. J Int Med Res. 37(6):1994-9, 2009
                                                16. Lee SK et al: Parotid incidentaloma identified by combined 18F-fluorodeoxyglucose whole-body positron emission tomography and computed tomography: findings at grayscale and power Doppler ultrasonography and ultrasound-guided fine-needle aspiration biopsy or core-needle biopsy. Eur Radiol. 19(9):2268-74, 2009
                                                17. Ch'ng S et al: Parotid and cervical nodal status predict prognosis for patients with head and neck metastatic cutaneous squamous cell carcinoma. J Surg Oncol. 98(2):101-5, 2008
                                                18. Hinerman RW et al: Cutaneous squamous cell carcinoma metastatic to parotid-area lymph nodes. Laryngoscope. 118(11):1989-96, 2008
                                                19. Veness MJ et al: Cutaneous head and neck squamous cell carcinoma metastatic to parotid and cervical lymph nodes. Head Neck. 29(7):621-31, 2007
                                                20. Ch'ng S et al: Parotid metastasis--an independent prognostic factor for head and neck cutaneous squamous cell carcinoma. J Plast Reconstr Aesthet Surg. 59(12):1288-93, 2006
                                                21. Bron LP et al: Primary and metastatic cancer of the parotid: comparison of clinical behavior in 232 cases. Laryngoscope. 113(6):1070-5, 2003
                                                22. Cole MD et al: Evaluation of nodal patterns for melanoma of the ear. Plast Reconstr Surg. 112(1):50-6, 2003
                                                23. O'Brien CJ et al: Significance of clinical stage, extent of surgery, and pathologic findings in metastatic cutaneous squamous carcinoma of the parotid gland. Head Neck. 24(5):417-22, 2002
                                                24. delCharco JO et al: Carcinoma of the skin metastatic to the parotid area lymph nodes. Head Neck. 20(5):369-73, 1998
                                                Related Anatomy
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                                                Related Differential Diagnoses
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                                                References
                                                Tables

                                                Tables

                                                KEY FACTS

                                                • Terminology

                                                  • Imaging

                                                    • Top Differential Diagnoses

                                                      • Pathology

                                                        • Clinical Issues

                                                          • Diagnostic Checklist

                                                            TERMINOLOGY

                                                            • Definitions

                                                              • Lymphangitic or hematogeneous tumor spread to intraparotid lymph nodes (systemic metastases)
                                                              • Parotid and periparotid nodes = 1st-order nodal station for skin squamous cell carcinoma (SCCa) and melanoma from scalp, auricle, and face (regional metastatic disease)

                                                            IMAGING

                                                            • General Features

                                                              • CT Findings

                                                                • MR Findings

                                                                  • Ultrasonographic Findings

                                                                    • Nuclear Medicine Findings

                                                                      • Imaging Recommendations

                                                                        DIFFERENTIAL DIAGNOSIS

                                                                          PATHOLOGY

                                                                          • General Features

                                                                            • Gross Pathologic & Surgical Features

                                                                              • Microscopic Features

                                                                                CLINICAL ISSUES

                                                                                • Presentation

                                                                                  • Demographics

                                                                                    • Natural History & Prognosis

                                                                                      • Treatment

                                                                                        DIAGNOSTIC CHECKLIST

                                                                                        • Consider

                                                                                          • Image Interpretation Pearls

                                                                                            • Reporting Tips

                                                                                              Selected References

                                                                                              1. Chen MM et al: Prognostic factors for squamous cell cancer of the parotid gland: an analysis of 2104 patients. Head Neck. 37(1):1-7, 2015
                                                                                              2. Pfisterer MJ et al: Squamous cell carcinoma of the parotid gland: a population-based analysis of 2545 cases. Am J Otolaryngol. 35(4):469-75, 2014
                                                                                              3. Sandu I et al: Misleading appearance in cervical lymph node US diagnosis - a report on sarcoidosis, Warthin tumor and squamous cell carcinoma metastases. Med Ultrason. 16(2):182-5, 2014
                                                                                              4. Udager AM et al: Metastatic renal cell carcinoma, clear cell type, of the parotid gland: a case report, review of literature, and proposed algorithmic approach to salivary gland clear cell neoplasms in fine-needle aspiration biopsies. Diagn Cytopathol. 42(11):974-83, 2014
                                                                                              5. Mansour N et al: Evaluation of parotid gland lesions with standard ultrasound, color duplex sonography, sonoelastography, and acoustic radiation force impulse imaging - a pilot study. Ultraschall Med. 33(3):283-8, 2012
                                                                                              6. Olsen SM et al: Oral cavity and oropharynx squamous cell carcinoma with metastasis to the parotid lymph nodes. Oral Oncol. 47(2):142-4, 2011
                                                                                              7. Peiffer N et al: Patterns of regional metastasis in advanced stage cutaneous squamous cell carcinoma of the auricle. Otolaryngol Head Neck Surg. 144(1):36-42, 2011
                                                                                              8. Sellinger M et al: Contralateral metastasis of parotid gland in advanced breast cancer with peripheral facial paralysis. Arch Gynecol Obstet. 284(6):1557-60, 2011
                                                                                              9. Guzzo M et al: Major and minor salivary gland tumors. Crit Rev Oncol Hematol. 74(2):134-48, 2010
                                                                                              10. Laco J et al: Tumor-to-tumor metastasis: Warthin tumor as a recipient of lung carcinoma and of renal carcinoma - Report of two cases. Pathol Res Pract. 206(7):458-62, 2010
                                                                                              11. Turner SJ et al: Metastatic cutaneous squamous cell carcinoma of the external ear: a high-risk cutaneous subsite. J Laryngol Otol. 124(1):26-31, 2010
                                                                                              12. Ulubas B et al: Small cell lung cancer diagnosed with metastasis in parotid gland. J Craniofac Surg. 21(3):781-3, 2010
                                                                                              13. Wang Z et al: Myoepithelial carcinoma of the parotid gland metastatic to the kidney: case report and review of the literature. Diagn Cytopathol. 38(4):279-82, 2010
                                                                                              14. Bangerter M: Cytomorphologic pitfall of primary malignant melanoma of the parotid gland: a case report. Acta Cytol. 53(4):435-6, 2009
                                                                                              15. Dong XR et al: Parotid gland metastasis of nasopharyngeal carcinoma: case report and review of the literature. J Int Med Res. 37(6):1994-9, 2009
                                                                                              16. Lee SK et al: Parotid incidentaloma identified by combined 18F-fluorodeoxyglucose whole-body positron emission tomography and computed tomography: findings at grayscale and power Doppler ultrasonography and ultrasound-guided fine-needle aspiration biopsy or core-needle biopsy. Eur Radiol. 19(9):2268-74, 2009
                                                                                              17. Ch'ng S et al: Parotid and cervical nodal status predict prognosis for patients with head and neck metastatic cutaneous squamous cell carcinoma. J Surg Oncol. 98(2):101-5, 2008
                                                                                              18. Hinerman RW et al: Cutaneous squamous cell carcinoma metastatic to parotid-area lymph nodes. Laryngoscope. 118(11):1989-96, 2008
                                                                                              19. Veness MJ et al: Cutaneous head and neck squamous cell carcinoma metastatic to parotid and cervical lymph nodes. Head Neck. 29(7):621-31, 2007
                                                                                              20. Ch'ng S et al: Parotid metastasis--an independent prognostic factor for head and neck cutaneous squamous cell carcinoma. J Plast Reconstr Aesthet Surg. 59(12):1288-93, 2006
                                                                                              21. Bron LP et al: Primary and metastatic cancer of the parotid: comparison of clinical behavior in 232 cases. Laryngoscope. 113(6):1070-5, 2003
                                                                                              22. Cole MD et al: Evaluation of nodal patterns for melanoma of the ear. Plast Reconstr Surg. 112(1):50-6, 2003
                                                                                              23. O'Brien CJ et al: Significance of clinical stage, extent of surgery, and pathologic findings in metastatic cutaneous squamous carcinoma of the parotid gland. Head Neck. 24(5):417-22, 2002
                                                                                              24. delCharco JO et al: Carcinoma of the skin metastatic to the parotid area lymph nodes. Head Neck. 20(5):369-73, 1998