BACKGROUND: Metastases from mucosal and @entity189 can present in a delayed fashion, and this late presentation may confer a different prognosis after conventional treatment. METHODS: We present a series of @entity1 in which there was a significant time delay between the treatment of a squamous @entity1489 or mucosa of the midface and the detection of regional @entity3 in 12 of the 13 cases. @entity5 were located on the lower lip and commissure (n = 3), nasal tip (n = 2), nasal ala (n = 1), columella (n = 1), nasofacial crease (n = 2), maxillary alveolus (n = 3), and mandibular alveolus (n = 1). Metastatic spread manifested by palpable perifacial or submandibular lymph nodes was not evident until greater than 11 months after the treatment of the primary site in 12 of 13 @entity1 (range, 3-45 months). Nine of the @entity1 were clinically staged as N1, whereas there was one each in the N2a, N2b, N2c, and N3 categories. Eleven of the 13 @entity1 were initially seen with palpable disease involving the perifacial nodes within or around the submandibular gland. All @entity1 were treated with neck dissection except one, who refused surgical treatment and underwent a second course of radiotherapy to the cervical region. The nine @entity1 initially seen with clinical stage N1 disease underwent neck dissection with preservation of the sternocleidomastoid, internal jugular vein, and accessory nerve. RESULTS: Of 10 @entity1 with perifacial node @entity3 who underwent neck dissection, 8 required sacrifice of the marginal mandibular nerve and overlying platysma to gain adequate margin. Extracapsular spread was present in 11 @entity1 , (8 of 9 who were clinically N1). Postoperative radiotherapy was recommended to all @entity1 with extracapsular spread, although only 7 of the 11 received radiotherapy. There were no regional recurrences after a minimum follow-up of 1 year (range, 12-65 months; mean, 31.4 months). Histologic grade appeared to have no influence on prognosis. CONCLUSIONS: This cohort demonstrates the ability of @entity957 to manifest regional metastatic disease over a delayed time. This delayed presentation appears to confer a more favorable response to treatment. For @entity5 , the perifacial nodes are at greatest risk for metastatic spread. For @entity5 in this region, primary treatment of the neck is probably not warranted, but careful extended follow-up for the potential of delayed cervical @entity3 is prudent.

Delayed regional @entity3 from XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity5 :: ('MESH:D009369', 'Disease') :: ['midfacial cancers', 'Primary tumors', 'tumors'] @entity1489 :: ('MESH:D012878', 'Disease') :: ['carcinoma of the skin'] @entity957 :: ('MESH:D002294', 'Disease') :: ['midfacial squamous cell carcinoma'] @entity189 :: ('MESH:D002277', 'Disease') :: ['cutaneous carcinomas'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis', 'metastases']
@entity957 :: (MESH:D002294,Disease) :: ['midfacial squamous carcinomas']
