BACKGROUND: Potential lymphatic drainage patterns from cutaneous @entity320 of the head and neck are said to be variable and frequently unpredictable. The aim of this article is to correlate the anatomic distribution of pathologically involved lymph nodes with primary @entity320 sites and to compare these findings with clinically predicted patterns of metastatic spread. METHODS: A prospectively documented series of 169 @entity1 with pathologically proven @entity320 was reviewed by analyzing the clinical, operative, and pathologic records. Clinically, it was predicted that @entity320 of the anterior scalp, forehead, and face could metastasize to the parotid and neck levels I-III; the coronal scalp, ear, and neck to the parotid and levels I-V; the posterior scalp to occipital nodes and levels II-V; and the lower neck to levels III-V. Minimum follow up was 2 years. RESULTS: There were 141 therapeutic (97 comprehensive, 44 selective) and 28 elective lymphadenectomies (4 comprehensive dissections, 21 selective neck dissections, and 3 cases in which parotidectomy alone was performed). Overall, there were 112 parotidectomies, 44 of which were therapeutic and 68 elective. Pathologically positive nodes involved clinically predicted nodal groups in 156 of 169 cases (92.3%). The incidence of postauricular node involvement was only 1.5% (3 cases). No @entity1 was initially seen with contralateral metastatic disease; however, 5 @entity1 (2.9%) failed in the contralateral neck after therapeutic dissection. In 68% of @entity1 , metastatic disease involved the nearest nodal group, and in 59% only a single node was involved. CONCLUSIONS: @entity320 of the head and neck metastasized to clinically predicted nodal groups in 92% of @entity1 in this series. Postauricular and contralateral metastatic node involvement was uncommon.

Do nodal metastases from cutaneous XXXX of the head and neck follow a clinically predictable pattern?

@entity1 :: ('9606', 'Species') :: ['patients', 'patient'] @entity320 :: ('MESH:D008545', 'Disease') :: ['melanoma', 'melanomas', 'Cutaneous malignant melanomas', 'metastatic melanoma']
@entity320 :: (MESH:D008545,Disease) :: ['melanoma']
