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84th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery

08.05. - 12.05.2013, Nürnberg

Axillary metastasis in head and neck cancer: two case reports

Meeting Abstract

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  • corresponding author presenting/speaker Julia Diana Dahm - Klinik für Hals-Nasen-Ohrenheilkunde, Kliniken Maria Hilf, Mönchengladbach, Germany
  • Susanne Wiegand - Universitätsklinikum Gießen und Marburg GmbH, Standort Marburg, Klinik für Hals-Nasen-Ohrenheilkunde, Marburg, Germany
  • Jochen Windfuhr - Klinik für Hals-Nasen-Ohren-Heilkunde, Kliniken Maria Hilf, Mönchengladbach, Germany

German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. 84th Annual Meeting of the German Society of Oto-Rhino-Laryngology, Head and Neck Surgery. Nürnberg, 08.-12.05.2013. Düsseldorf: German Medical Science GMS Publishing House; 2013. Doc13hno06

doi: 10.3205/13hno06, urn:nbn:de:0183-13hno060

Published: July 30, 2013

© 2013 Dahm et al.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( You are free: to Share – to copy, distribute and transmit the work, provided the original author and source are credited.



Introduction: Axillary metastasis secondary to squamous cell carcinoma (SCC) of the head and neck are extremely rare. To the best of our knowledge, only six patients with cancer of the larynx and two with oropharyngeal cancer were reported in the literature over the last four decades.

Case Reports: A 64-year-old man with a relapse of a laryngeal carcinoma after laser surgery was treated with laryngectomy and neck dissection. Three years later a peritracheal recurrent tumor growth was diagnosed. The patient underwent hemithyreoidectomy, tracheal resection and radiochemotherapy. An axilary swelling was noted after one year and the patient scheduled for axillary lymphadenectomy. Local axillary recurrence after another year was treated by radical lymphadenectomy and radiochemotherapy. He is recurrence-free for 20 month now. A second, 55 year-old patient with an oropharyngeal SCC was treated by laser surgery, neck dissection and radiochemotherapy. Three years later a local recurrence with cervical nodal metastasis was treated by brachytherapy and neck dissection. An mandibular osteoradionecrosis requiring plastic reconstructive surgery with a free radial forearm flap. Seven years later the patient noticed an axillary swelling which was found to be solitary in PET-CT. Therefore, radical axillary lymphadenectomy and radiochemotherapy was undertaken. Two years later a local axillary recurrent tumor was diagnosed. Palliative chemotherapy was cancelled due to progressive tumour growth.

Conclusion: Radical surgery of the neck region obviously has an impact on the lymphatic drainage. Alternative lymphatic drainage pathways may result in unusual axillary metastasis in cases of head and neck cancer. This should be considered in the oncological follow-up.