Metastatic squamous cell carcinoma to the superior cervical ganglion mimicking a retropharyngeal lymph node

Publication date: Available online 5 July 2017
Source:American Journal of Otolaryngology
Author(s): Sami P. Moubayed, Rosalie Machado, Marcela Osorio, Azita Khorsandi, Juan Hernandez-Prera, Mark L. Urken
BackgroundMetastasis of squamous cell carcinoma (SCC) to the superior cervical ganglion (SCG) has never been reported. Its anatomic location may easily be mistaken for a retropharyngeal lymph node. We present the first case of SCC metastasis to the SCG.MethodsWe report a case of a 69year-old never smoking male, who presented with right retropharyngeal PETCT-avid disease following chemoradiation for squamous cell carcinoma of the tonsil. He was brought to the operating room for resection, intraoperative radiation and reconstruction.ResultsIntraoperatively, visualization and frozen section confirmed squamous cell carcinoma located in the superior cervical ganglion. The ganglion was resected, intraoperative radiation was given and the patient was reconstructed with a radial forearm free flap. Postoperatively, the patient displayed features of a Horner's syndrome.ConclusionsThe superior cervical ganglion may be mistaken for a retropharyngeal lymph node. Although extremely rare, these entities may be differentiated on the basis of radiological studies.



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