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Head and Neck
Diagnosis
Retropharyngeal Space
Metastatic Tumors
Non-Squamous Cell Carcinoma Metastatic Nodes in Retropharyngeal Space
Non-Squamous Cell Carcinoma Metastatic Nodes in Retropharyngeal Space
Bronwyn E. Hamilton, MD
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KEY FACTS

  • Terminology

    • Imaging

      • Top Differential Diagnoses

        • Clinical Issues

          • Diagnostic Checklist

            TERMINOLOGY

            • Abbreviations

              • Non-squamous cell carcinoma (SCCa) metastatic nodes in retropharyngeal space (RPS)

            • Definitions

              • Malignant RPS nodes of non-SCCa origin
                • Thyroid cancers [differentiated thyroid carcinoma (DTCa), medullary thyroid carcinoma (MTC), & anaplastic], melanoma, esthesioneuroblastoma (ENB), sinonasal undifferentiated carcinoma (SNUC), non-Hodgkin lymphoma (NHL)
              • Node of Rouvière = lateral group of RPS nodes

            IMAGING

            • General Features

              • Imaging Recommendations

                • CT Findings

                  • MR Findings

                    • Nuclear Medicine Findings

                      DIFFERENTIAL DIAGNOSIS

                        PATHOLOGY

                        • General Features

                          CLINICAL ISSUES

                          • Presentation

                            • Natural History & Prognosis

                              • Treatment

                                DIAGNOSTIC CHECKLIST

                                • Consider

                                  Selected References

                                  1. Aiken AH et al: Approach to masses in head and neck spaces. In 2020 in Diseases of the Brain, Head and Neck, Spine: Diagnostic Imaging. Hodler J et al. Springer; 2020–3, 2020
                                  2. Harries V et al: Management of retropharyngeal lymph node metastases in differentiated thyroid carcinoma. Thyroid. 30(5):688-95, 2020
                                  3. Mnatsakanian A et al: Anatomy, head and neck, retropharyngeal space. StatPearls, 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. Batchala PP et al: Retropharyngeal ectopic parathyroid adenoma versus lymph node: problem solving with CT neck angiogram. J Postgrad Med. 65(4):237-40, 2019
                                  6. Fard N et al: CT- and ultrasound-characteristics of hepatic lesions in patients with multiple endocrine neoplasia syndrome. A retrospective image review of 25 cases. PLoS One. 14(2):e0212865, 2019
                                  7. Gan Q et al: Cytologic evaluation of positron emission tomography-computed tomography-positive lymph nodes sampled by endobronchial ultrasound-guided transbronchial needle aspiration: experience at a large cancer center. Arch Pathol Lab Med. 143(10):1265-70, 2019
                                  8. Kushchayev SV et al: Medullary thyroid carcinoma: an update on imaging. J Thyroid Res. 2019:1893047, 2019
                                  9. Morsing A et al: Hybrid PET/MRI in major cancers: a scoping review. Eur J Nucl Med Mol Imaging. 46(10):2138-51, 2019
                                  10. Vu TH et al: Diagnostic accuracy and scope of intraoperative transoral ultrasound and transoral ultrasound-guided fine-needle aspiration of retropharyngeal masses. AJNR Am J Neuroradiol. 40(11):1960-4, 2019
                                  11. Ahmed S et al: Imaging of anaplastic thyroid carcinoma. AJNR Am J Neuroradiol. 39(3):547-51, 2017
                                  12. Hartl DM et al: Management of retropharyngeal node metastases from thyroid carcinoma. World J Surg. 39(5):1274-81, 2015
                                  13. Li H et al: Diffusion-weighted imaging to differentiate metastatic from non-metastatic retropharyngeal lymph nodes in nasopharyngeal carcinoma. Dentomaxillofac Radiol. 44(3):20140126, 2015
                                  14. Kato H et al: Metastatic retropharyngeal lymph nodes: comparison of CT and MR imaging for diagnostic accuracy. Eur J Radiol. 83(7):1157-62, 2014
                                  15. Saindane AM: Pitfalls in the staging of cancer of thyroid. Neuroimaging Clin N Am. 23(1):123-45, 2013
                                  16. Kainuma K et al: The first report of bilateral retropharyngeal lymph node metastasis from papillary thyroid carcinoma and review of the literature. Acta Otolaryngol. 131(12):1341-8, 2011
                                  17. 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
                                  18. Haas V et al: Unusual manifestation of anaplastic thyroid cancer. Acta Medica (Hradec Kralove). 51(4):233-6, 2008
                                  19. Zollinger LV et al: Retropharyngeal lymph node metastasis from esthesioneuroblastoma: a review of the therapeutic and prognostic implications. AJNR Am J Neuroradiol. 29(8):1561-3, 2008
                                  20. Liu T et al: FDG-PET, CT, MRI for diagnosis of local residual or recurrent nasopharyngeal carcinoma, which one is the best? A systematic review. Radiother Oncol. 85(3):327-35, 2007
                                  21. McMenamin DS et al: T1 hyperintense vertebral column melanoma metastases. AJNR Am J Neuroradiol. 28(9):1817-8, 2007
                                  22. Otsuki N et al: Retropharyngeal node metastasis from papillary thyroid carcinoma. Head Neck. 29(5):508-11, 2007
                                  23. Shellenberger T et al: Transoral resection of thyroid cancer metastasis to lateral retropharyngeal nodes. Head Neck. 29(3):258-66, 2007
                                  24. Tang LL et al: [The values of MRI, CT, and PET-CT in detecting retropharyngeal lymph node metastasis of nasopharyngeal carcinoma.] Ai Zheng. 26(7):737-41, 2007
                                  25. Kim HJ et al: Retropharyngeal lymph node metastasis from olfactory neuroblastoma: a report of two cases. Eur Arch Otorhinolaryngol. 263(8):778-82, 2006
                                  26. Fernández JM et al: Preliminary study of the lymphatic drainage system of the nose and paranasal sinuses and its role in detection of sentinel metastatic nodes. Acta Otolaryngol. 125(5):566-70, 2005
                                  27. Morrissey DD et al: Accuracy of computed tomography in determining the presence or absence of metastatic retropharyngeal adenopathy. Arch Otolaryngol Head Neck Surg. 126(12):1478-81, 2000
                                  28. Wagner JD et al: Metastatic melanoma to retropharyngeal lymph nodes causing pharyngeal obstruction. Ann Plast Surg. 40(1):84-7, 1998
                                  29. Premkumar A et al: Metastatic melanoma: correlation of MRI characteristics and histopathology. J Magn Reson Imaging. 6(1):190-4, 1996
                                  30. Robbins KT et al: Thyroid carcinoma presenting as a parapharyngeal mass. Head Neck Surg. 7(5):434-6, 1985
                                  31. Mancuso AA et al: Computed tomography of cervical and retropharyngeal lymph nodes: normal anatomy, variants of normal, and applications in staging head and neck cancer. Part II: pathology. Radiology. 148(3):715-23, 1983
                                  Related Anatomy
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                                  Related Differential Diagnoses
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                                  References
                                  Tables

                                  Tables

                                  KEY FACTS

                                  • Terminology

                                    • Imaging

                                      • Top Differential Diagnoses

                                        • Clinical Issues

                                          • Diagnostic Checklist

                                            TERMINOLOGY

                                            • Abbreviations

                                              • Non-squamous cell carcinoma (SCCa) metastatic nodes in retropharyngeal space (RPS)

                                            • Definitions

                                              • Malignant RPS nodes of non-SCCa origin
                                                • Thyroid cancers [differentiated thyroid carcinoma (DTCa), medullary thyroid carcinoma (MTC), & anaplastic], melanoma, esthesioneuroblastoma (ENB), sinonasal undifferentiated carcinoma (SNUC), non-Hodgkin lymphoma (NHL)
                                              • Node of Rouvière = lateral group of RPS nodes

                                            IMAGING

                                            • General Features

                                              • Imaging Recommendations

                                                • CT Findings

                                                  • MR Findings

                                                    • Nuclear Medicine Findings

                                                      DIFFERENTIAL DIAGNOSIS

                                                        PATHOLOGY

                                                        • General Features

                                                          CLINICAL ISSUES

                                                          • Presentation

                                                            • Natural History & Prognosis

                                                              • Treatment

                                                                DIAGNOSTIC CHECKLIST

                                                                • Consider

                                                                  Selected References

                                                                  1. Aiken AH et al: Approach to masses in head and neck spaces. In 2020 in Diseases of the Brain, Head and Neck, Spine: Diagnostic Imaging. Hodler J et al. Springer; 2020–3, 2020
                                                                  2. Harries V et al: Management of retropharyngeal lymph node metastases in differentiated thyroid carcinoma. Thyroid. 30(5):688-95, 2020
                                                                  3. Mnatsakanian A et al: Anatomy, head and neck, retropharyngeal space. StatPearls, 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. Batchala PP et al: Retropharyngeal ectopic parathyroid adenoma versus lymph node: problem solving with CT neck angiogram. J Postgrad Med. 65(4):237-40, 2019
                                                                  6. Fard N et al: CT- and ultrasound-characteristics of hepatic lesions in patients with multiple endocrine neoplasia syndrome. A retrospective image review of 25 cases. PLoS One. 14(2):e0212865, 2019
                                                                  7. Gan Q et al: Cytologic evaluation of positron emission tomography-computed tomography-positive lymph nodes sampled by endobronchial ultrasound-guided transbronchial needle aspiration: experience at a large cancer center. Arch Pathol Lab Med. 143(10):1265-70, 2019
                                                                  8. Kushchayev SV et al: Medullary thyroid carcinoma: an update on imaging. J Thyroid Res. 2019:1893047, 2019
                                                                  9. Morsing A et al: Hybrid PET/MRI in major cancers: a scoping review. Eur J Nucl Med Mol Imaging. 46(10):2138-51, 2019
                                                                  10. Vu TH et al: Diagnostic accuracy and scope of intraoperative transoral ultrasound and transoral ultrasound-guided fine-needle aspiration of retropharyngeal masses. AJNR Am J Neuroradiol. 40(11):1960-4, 2019
                                                                  11. Ahmed S et al: Imaging of anaplastic thyroid carcinoma. AJNR Am J Neuroradiol. 39(3):547-51, 2017
                                                                  12. Hartl DM et al: Management of retropharyngeal node metastases from thyroid carcinoma. World J Surg. 39(5):1274-81, 2015
                                                                  13. Li H et al: Diffusion-weighted imaging to differentiate metastatic from non-metastatic retropharyngeal lymph nodes in nasopharyngeal carcinoma. Dentomaxillofac Radiol. 44(3):20140126, 2015
                                                                  14. Kato H et al: Metastatic retropharyngeal lymph nodes: comparison of CT and MR imaging for diagnostic accuracy. Eur J Radiol. 83(7):1157-62, 2014
                                                                  15. Saindane AM: Pitfalls in the staging of cancer of thyroid. Neuroimaging Clin N Am. 23(1):123-45, 2013
                                                                  16. Kainuma K et al: The first report of bilateral retropharyngeal lymph node metastasis from papillary thyroid carcinoma and review of the literature. Acta Otolaryngol. 131(12):1341-8, 2011
                                                                  17. 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
                                                                  18. Haas V et al: Unusual manifestation of anaplastic thyroid cancer. Acta Medica (Hradec Kralove). 51(4):233-6, 2008
                                                                  19. Zollinger LV et al: Retropharyngeal lymph node metastasis from esthesioneuroblastoma: a review of the therapeutic and prognostic implications. AJNR Am J Neuroradiol. 29(8):1561-3, 2008
                                                                  20. Liu T et al: FDG-PET, CT, MRI for diagnosis of local residual or recurrent nasopharyngeal carcinoma, which one is the best? A systematic review. Radiother Oncol. 85(3):327-35, 2007
                                                                  21. McMenamin DS et al: T1 hyperintense vertebral column melanoma metastases. AJNR Am J Neuroradiol. 28(9):1817-8, 2007
                                                                  22. Otsuki N et al: Retropharyngeal node metastasis from papillary thyroid carcinoma. Head Neck. 29(5):508-11, 2007
                                                                  23. Shellenberger T et al: Transoral resection of thyroid cancer metastasis to lateral retropharyngeal nodes. Head Neck. 29(3):258-66, 2007
                                                                  24. Tang LL et al: [The values of MRI, CT, and PET-CT in detecting retropharyngeal lymph node metastasis of nasopharyngeal carcinoma.] Ai Zheng. 26(7):737-41, 2007
                                                                  25. Kim HJ et al: Retropharyngeal lymph node metastasis from olfactory neuroblastoma: a report of two cases. Eur Arch Otorhinolaryngol. 263(8):778-82, 2006
                                                                  26. Fernández JM et al: Preliminary study of the lymphatic drainage system of the nose and paranasal sinuses and its role in detection of sentinel metastatic nodes. Acta Otolaryngol. 125(5):566-70, 2005
                                                                  27. Morrissey DD et al: Accuracy of computed tomography in determining the presence or absence of metastatic retropharyngeal adenopathy. Arch Otolaryngol Head Neck Surg. 126(12):1478-81, 2000
                                                                  28. Wagner JD et al: Metastatic melanoma to retropharyngeal lymph nodes causing pharyngeal obstruction. Ann Plast Surg. 40(1):84-7, 1998
                                                                  29. Premkumar A et al: Metastatic melanoma: correlation of MRI characteristics and histopathology. J Magn Reson Imaging. 6(1):190-4, 1996
                                                                  30. Robbins KT et al: Thyroid carcinoma presenting as a parapharyngeal mass. Head Neck Surg. 7(5):434-6, 1985
                                                                  31. Mancuso AA et al: Computed tomography of cervical and retropharyngeal lymph nodes: normal anatomy, variants of normal, and applications in staging head and neck cancer. Part II: pathology. Radiology. 148(3):715-23, 1983