Nodal Metastases in Head and Neck Skin Squamous Cell Carcinomas

Cutaneous squamous cell carcinoma (cSCC) is the second most common histotype among non-melanoma skin cancers, the most frequent malignancies in humans, which most often arise in the head and neck region. In general, regional metastasis is relatively uncommon (less than 5%), but in high-risk head and neck cSCC (hncSCC) the likelihood of parotid or cervical node spread increases and, even in the clinical absence of involvement of the lymph basin, radiological exams and even elective treatment can be recommended. Involvement of parotid nodes, differently than in mucosal SCC, is pretty common in hncSCC. Ultrasound-guided fine needle cytology is a powerful tool along the diagnostic work-up. Neck dissection, together with parotidectomy when the salivary gland nodes are involved or according to the site of origin of hncSCC, is usually the treatment of choice for the neck, possibly followed by adjuvant treatment (external beam radiotherapy + chemotherapy) based upon histopathological findings.