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Nodal Squamous Cell Carcinoma of Retropharyngeal Space
Bronwyn E. Hamilton, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Pathology

          • Clinical Issues

            TERMINOLOGY

            • Definitions

              • Malignant retropharyngeal space (RPS) nodes: Squamous cell carcinoma (SCCa) RPS nodes from nasopharyngeal carcinoma (NPCa), posterior wall oropharyngeal, or hypopharyngeal primary SCCa

            IMAGING

            • General Features

              • CT Findings

                • MR Findings

                  • Nuclear Medicine Findings

                    • Imaging Recommendations

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          CLINICAL ISSUES

                          • Presentation

                            • Demographics

                              • Natural History & Prognosis

                                • Treatment

                                  DIAGNOSTIC CHECKLIST

                                  • Consider

                                    Selected References

                                    1. Chen J et al: Evaluation of contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) in the detection of retropharyngeal lymph node metastases in nasopharyngeal carcinoma patients. Cancer Manag Res. 12:1733-9, 2020
                                    2. Iyizoba-Ebozue Z et al: Incidence and patterns of retropharyngeal lymph node involvement in oropharyngeal carcinoma. Radiother Oncol. 142:92-9, 2020
                                    3. Li WZ et al: MRI-detected residual retropharyngeal lymph node after intensity-modulated radiotherapy in nasopharyngeal carcinoma: prognostic value and a nomogram for the pretherapy prediction of it. Radiother Oncol. 145:101-8, 2020
                                    4. So TY et al: Intravoxel incoherent motion diffusion-weighted imaging for discrimination of benign and malignant retropharyngeal nodes. Neuroradiology. 62(12):1667-76, 2020
                                    5. Huang L et al: Prognostic value of retropharyngeal lymph node metastasis laterality in nasopharyngeal carcinoma and a proposed modification to the UICC/AJCC N staging system. Radiother Oncol. 140:90-7, 2019
                                    6. Iyizoba-Ebozue Z et al: Retropharyngeal lymph node involvement in oropharyngeal carcinoma: impact upon risk of distant metastases and survival outcomes. Cancers (Basel). 12(1), 2019
                                    7. Oikawa Y et al: Management of retropharyngeal lymph node metastasis in oral cancer. Oral Oncol. 99:104471, 2019
                                    8. Teshima M et al: Impact of retropharyngeal lymph node dissection in the surgical treatment of hypopharyngeal cancer. Head Neck. 41(6):1738-44, 2019
                                    9. Loke SC et al: Superior cervical ganglion mimicking retropharyngeal adenopathy in head and neck cancer patients: MRI features with anatomic, histologic, and surgical correlation. Neuroradiology. 58(1):45-50, 2016
                                    10. Suzuki T et al: Effectiveness of superselective intra-arterial chemoradiotherapy targeting retropharyngeal lymph node metastasis. Eur Arch Otorhinolaryngol. 273(10):3331-6, 2016
                                    11. Wu IS et al: Is unenhanced 18F-FDG-PET/CT better than enhanced CT in the detection of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma? Ear Nose Throat J. 95(4-5):178-84, 2016
                                    12. Byeon HK et al: Transoral robotic retropharyngeal lymph node dissection with or without lateral oropharyngectomy. J Craniofac Surg. 24(4):1156-61, 2013
                                    13. Gunn GB et al: The impact of radiographic retropharyngeal adenopathy in oropharyngeal cancer. Cancer. 119(17):3162-9, 2013
                                    14. Tang C et al: Radiologic assessment of retropharyngeal node involvement in oropharyngeal carcinomas stratified by HPV status. Radiother Oncol. 109(2):293-6, 2013
                                    15. Harada R et al: The incidence and significance of retropharyngeal lymph node metastases in hypopharyngeal cancer. Jpn J Clin Oncol. 42(9):794-9, 2012
                                    16. Ho FC et al: Patterns of regional lymph node metastasis of nasopharyngeal carcinoma: a meta-analysis of clinical evidence. BMC Cancer. 12:98, 2012
                                    17. Coskun HH et al: Retropharyngeal lymph node metastases in head and neck malignancies. Head Neck. 33(10):1520-9, 2011
                                    18. Chen YB et al: Optimization of magnetic resonance sequences in lymph node staging of nasopharyngeal carcinoma. Chin Med J (Engl). 123(4):443-6, 2010
                                    19. Deng XY et al: Analysis of cervical and retropharyngeal lymph node metastases in the patients with hypopharyngeal carcinoma with computed tomography and magnetic resonance imaging. Chin J Cancer. 29(2):189-93, 2010
                                    20. Tauzin M et al: PET-CT staging of the neck in cancers of the oropharynx: patterns of regional and retropharyngeal nodal metastasis. World J Surg Oncol. 8:70, 2010
                                    21. Chu HR et al: Additional diagnostic value of (18)F-FDG PET-CT in detecting retropharyngeal nodal metastases. Otolaryngol Head Neck Surg. 141(5):633-8, 2009
                                    22. Kamiyama R et al: Significance of retropharyngeal lymph node dissection in hypopharyngeal cancer. Jpn J Clin Oncol. 39(10):632-7, 2009
                                    23. Kaplan SL et al: The role of MR imaging in detecting nodal disease in thyroidectomy patients with rising thyroglobulin levels. AJNR Am J Neuroradiol. 30(3):608-12, 2009
                                    24. Tang L et al: The volume to be irradiated during selective neck irradiation in nasopharyngeal carcinoma: analysis of the spread patterns in lymph nodes by magnetic resonance imaging. Cancer. 115(3):680-8, 2009
                                    25. Tham IW et al: Retropharyngeal nodal metastasis related to higher rate of distant metastasis in patients with N0 and N1 nasopharyngeal cancer. Head Neck. 31(4):468-74, 2009
                                    26. Umeda M et al: Metastasis to the lateral retropharyngeal lymph node from squamous cell carcinoma of the oral cavity: report of three cases. Int J Oral Maxillofac Surg. 38(9):1004-8, 2009
                                    27. Wang XS et al: Patterns of retropharyngeal node metastasis in nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 73(1):194-201, 2009
                                    28. Mao YP et al: The N staging system in nasopharyngeal carcinoma with radiation therapy oncology group guidelines for lymph node levels based on magnetic resonance imaging. Clin Cancer Res. 14(22):7497-503, 2008
                                    29. Tang L et al: Retropharyngeal lymph node metastasis in nasopharyngeal carcinoma detected by magnetic resonance imaging : prognostic value and staging categories. Cancer. 113(2):347-54, 2008
                                    30. Dirix P et al: Prognostic influence of retropharyngeal lymph node metastasis in squamous cell carcinoma of the oropharynx. Int J Radiat Oncol Biol Phys. 65(3):739-44, 2006
                                    31. Shimizu K et al: Distribution and impact of lymph node metastases in oropharyngeal cancer. Acta Otolaryngol. 126(8):872-7, 2006
                                    32. Gross ND et al: Impact of retropharyngeal lymph node metastasis in head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 130(2):169-73, 2004
                                    33. King AD et al: Neck node metastases from nasopharyngeal carcinoma: MR imaging of patterns of disease. Head Neck. 22(3):275-81, 2000
                                    34. Kimura Y et al: Lateral retropharyngeal node metastasis from carcinoma of the upper gingiva and maxillary sinus. AJNR Am J Neuroradiol. 19(7):1221-4, 1998
                                    35. Lam WW et al: Retropharyngeal lymphadenopathy in nasopharyngeal carcinoma. Head Neck. 19(3):176-81, 1997
                                    36. McLaughlin MP et al: Retropharyngeal adenopathy as a predictor of outcome in squamous cell carcinoma of the head and neck. Head Neck. 17(3):190-8, 1995
                                    37. Hasegawa Y et al: Retropharyngeal node dissection in cancer of the oropharynx and hypopharynx. Head Neck. 16(2):173-80, 1994
                                    38. Watarai J et al: CT of retropharyngeal lymph node metastasis from maxillary carcinoma. Acta Radiol. 34(5):492-5, 1993
                                    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

                                              TERMINOLOGY

                                              • Definitions

                                                • Malignant retropharyngeal space (RPS) nodes: Squamous cell carcinoma (SCCa) RPS nodes from nasopharyngeal carcinoma (NPCa), posterior wall oropharyngeal, or hypopharyngeal primary SCCa

                                              IMAGING

                                              • General Features

                                                • CT Findings

                                                  • MR Findings

                                                    • Nuclear Medicine Findings

                                                      • Imaging Recommendations

                                                        DIFFERENTIAL DIAGNOSIS

                                                          PATHOLOGY

                                                          • General Features

                                                            CLINICAL ISSUES

                                                            • Presentation

                                                              • Demographics

                                                                • Natural History & Prognosis

                                                                  • Treatment

                                                                    DIAGNOSTIC CHECKLIST

                                                                    • Consider

                                                                      Selected References

                                                                      1. Chen J et al: Evaluation of contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI) in the detection of retropharyngeal lymph node metastases in nasopharyngeal carcinoma patients. Cancer Manag Res. 12:1733-9, 2020
                                                                      2. Iyizoba-Ebozue Z et al: Incidence and patterns of retropharyngeal lymph node involvement in oropharyngeal carcinoma. Radiother Oncol. 142:92-9, 2020
                                                                      3. Li WZ et al: MRI-detected residual retropharyngeal lymph node after intensity-modulated radiotherapy in nasopharyngeal carcinoma: prognostic value and a nomogram for the pretherapy prediction of it. Radiother Oncol. 145:101-8, 2020
                                                                      4. So TY et al: Intravoxel incoherent motion diffusion-weighted imaging for discrimination of benign and malignant retropharyngeal nodes. Neuroradiology. 62(12):1667-76, 2020
                                                                      5. Huang L et al: Prognostic value of retropharyngeal lymph node metastasis laterality in nasopharyngeal carcinoma and a proposed modification to the UICC/AJCC N staging system. Radiother Oncol. 140:90-7, 2019
                                                                      6. Iyizoba-Ebozue Z et al: Retropharyngeal lymph node involvement in oropharyngeal carcinoma: impact upon risk of distant metastases and survival outcomes. Cancers (Basel). 12(1), 2019
                                                                      7. Oikawa Y et al: Management of retropharyngeal lymph node metastasis in oral cancer. Oral Oncol. 99:104471, 2019
                                                                      8. Teshima M et al: Impact of retropharyngeal lymph node dissection in the surgical treatment of hypopharyngeal cancer. Head Neck. 41(6):1738-44, 2019
                                                                      9. Loke SC et al: Superior cervical ganglion mimicking retropharyngeal adenopathy in head and neck cancer patients: MRI features with anatomic, histologic, and surgical correlation. Neuroradiology. 58(1):45-50, 2016
                                                                      10. Suzuki T et al: Effectiveness of superselective intra-arterial chemoradiotherapy targeting retropharyngeal lymph node metastasis. Eur Arch Otorhinolaryngol. 273(10):3331-6, 2016
                                                                      11. Wu IS et al: Is unenhanced 18F-FDG-PET/CT better than enhanced CT in the detection of retropharyngeal lymph node metastasis in nasopharyngeal carcinoma? Ear Nose Throat J. 95(4-5):178-84, 2016
                                                                      12. Byeon HK et al: Transoral robotic retropharyngeal lymph node dissection with or without lateral oropharyngectomy. J Craniofac Surg. 24(4):1156-61, 2013
                                                                      13. Gunn GB et al: The impact of radiographic retropharyngeal adenopathy in oropharyngeal cancer. Cancer. 119(17):3162-9, 2013
                                                                      14. Tang C et al: Radiologic assessment of retropharyngeal node involvement in oropharyngeal carcinomas stratified by HPV status. Radiother Oncol. 109(2):293-6, 2013
                                                                      15. Harada R et al: The incidence and significance of retropharyngeal lymph node metastases in hypopharyngeal cancer. Jpn J Clin Oncol. 42(9):794-9, 2012
                                                                      16. Ho FC et al: Patterns of regional lymph node metastasis of nasopharyngeal carcinoma: a meta-analysis of clinical evidence. BMC Cancer. 12:98, 2012
                                                                      17. Coskun HH et al: Retropharyngeal lymph node metastases in head and neck malignancies. Head Neck. 33(10):1520-9, 2011
                                                                      18. Chen YB et al: Optimization of magnetic resonance sequences in lymph node staging of nasopharyngeal carcinoma. Chin Med J (Engl). 123(4):443-6, 2010
                                                                      19. Deng XY et al: Analysis of cervical and retropharyngeal lymph node metastases in the patients with hypopharyngeal carcinoma with computed tomography and magnetic resonance imaging. Chin J Cancer. 29(2):189-93, 2010
                                                                      20. Tauzin M et al: PET-CT staging of the neck in cancers of the oropharynx: patterns of regional and retropharyngeal nodal metastasis. World J Surg Oncol. 8:70, 2010
                                                                      21. Chu HR et al: Additional diagnostic value of (18)F-FDG PET-CT in detecting retropharyngeal nodal metastases. Otolaryngol Head Neck Surg. 141(5):633-8, 2009
                                                                      22. Kamiyama R et al: Significance of retropharyngeal lymph node dissection in hypopharyngeal cancer. Jpn J Clin Oncol. 39(10):632-7, 2009
                                                                      23. Kaplan SL et al: The role of MR imaging in detecting nodal disease in thyroidectomy patients with rising thyroglobulin levels. AJNR Am J Neuroradiol. 30(3):608-12, 2009
                                                                      24. Tang L et al: The volume to be irradiated during selective neck irradiation in nasopharyngeal carcinoma: analysis of the spread patterns in lymph nodes by magnetic resonance imaging. Cancer. 115(3):680-8, 2009
                                                                      25. Tham IW et al: Retropharyngeal nodal metastasis related to higher rate of distant metastasis in patients with N0 and N1 nasopharyngeal cancer. Head Neck. 31(4):468-74, 2009
                                                                      26. Umeda M et al: Metastasis to the lateral retropharyngeal lymph node from squamous cell carcinoma of the oral cavity: report of three cases. Int J Oral Maxillofac Surg. 38(9):1004-8, 2009
                                                                      27. Wang XS et al: Patterns of retropharyngeal node metastasis in nasopharyngeal carcinoma. Int J Radiat Oncol Biol Phys. 73(1):194-201, 2009
                                                                      28. Mao YP et al: The N staging system in nasopharyngeal carcinoma with radiation therapy oncology group guidelines for lymph node levels based on magnetic resonance imaging. Clin Cancer Res. 14(22):7497-503, 2008
                                                                      29. Tang L et al: Retropharyngeal lymph node metastasis in nasopharyngeal carcinoma detected by magnetic resonance imaging : prognostic value and staging categories. Cancer. 113(2):347-54, 2008
                                                                      30. Dirix P et al: Prognostic influence of retropharyngeal lymph node metastasis in squamous cell carcinoma of the oropharynx. Int J Radiat Oncol Biol Phys. 65(3):739-44, 2006
                                                                      31. Shimizu K et al: Distribution and impact of lymph node metastases in oropharyngeal cancer. Acta Otolaryngol. 126(8):872-7, 2006
                                                                      32. Gross ND et al: Impact of retropharyngeal lymph node metastasis in head and neck squamous cell carcinoma. Arch Otolaryngol Head Neck Surg. 130(2):169-73, 2004
                                                                      33. King AD et al: Neck node metastases from nasopharyngeal carcinoma: MR imaging of patterns of disease. Head Neck. 22(3):275-81, 2000
                                                                      34. Kimura Y et al: Lateral retropharyngeal node metastasis from carcinoma of the upper gingiva and maxillary sinus. AJNR Am J Neuroradiol. 19(7):1221-4, 1998
                                                                      35. Lam WW et al: Retropharyngeal lymphadenopathy in nasopharyngeal carcinoma. Head Neck. 19(3):176-81, 1997
                                                                      36. McLaughlin MP et al: Retropharyngeal adenopathy as a predictor of outcome in squamous cell carcinoma of the head and neck. Head Neck. 17(3):190-8, 1995
                                                                      37. Hasegawa Y et al: Retropharyngeal node dissection in cancer of the oropharynx and hypopharynx. Head Neck. 16(2):173-80, 1994
                                                                      38. Watarai J et al: CT of retropharyngeal lymph node metastasis from maxillary carcinoma. Acta Radiol. 34(5):492-5, 1993