Abstract
A rare case of unknown origin neck metastasis is reported, in which the primary site was revealed to be the maxillary sinus six years later.
A 18-year-old man was admitted to our hospital with a right cervical mass in 1993.
The histological diagnosis was metastatic squamous cell carcinoma. Further examinations including the paranasal sinus did not reveal the primary lesion. After preoperative irradiation including the epipharynx, right neck dissection was performed with postoperative adjuvant chemotherapy.
Four years after first admission the patient exhibited left cervical lymphadenopathy. Left neck dissection was carried out but the primary site was still unknown.
Two years after the second surgery the patient exhibited right nasal obstruction and rhinorrhea, and CT scan revealed right maxillary tumor. Total maxillectomy was performed after preoperative radiation therapy and the patient has shown an uneventful good clinical course to date.
In conclusion, in cases of unknown origin neck lymphnode metastasis it may be important to examine the paranasal sinus.
