Clinical Analysis Of Nasopharyngeal Carcinaoma With Parotid Lymph Node Metastasis

Objective To explore the incidence and pattern of parotid lymph node metastasis from nasopharyngeal carcinoma,and to analyze the possible mechanisms and prognosis.Methods and Materials Data of 1004 patients with pathologically confirmed nasopharyngeal carcinoma were retrospectively collected. The MRI was reviewed, and the imaging characters of those with parotid metastasis were analyzed. The clinical outcomes were also evaluated.Results Of the 1004 patients, 15 presented with parotid lesions, and 14 were eventually diagnosed as parotid metastasis according to the criteria, so the incidence rate was 1.4%. 82% of the metastatic parotid lymph node were situated in the superficial lobe. 93% of patients had advanced diseases; 43% had N3 diseases; 9 patients(64%) had cervical nodes extranodal spread of which 7 cases hadâ…¡a andâ…¡b extranodal spread ; 79% extended to parapharyngeal space; and 36% had received neck intervention before radiotherapy. After a median follow-up of 10.5 months, 6 cases occurred distant metastasis, of which two cases had died.Conclusion The incidence of parotid lymph node metastasis from nasopharyngeal carcinoma is 1.4%. Most of the metastases are in the superficial lobe. The possible metastatic mechanisms might be:neck node >6cm;â…¡a andâ…¡b extranodal spread ; parapharyngeal space occupied by tumor; and previous intervention of the neck. The prognosis of nasopharyngeal carcinoma with parotid node metastasis might be poor.