Anatomy Location Most Common Lymphatic Spread Metastatic Spread Staging Note
Pathology
Brain —Metastatic None —Local invasion GTM
—Adult Primary: —CSF spread
glioblastoma
multiforme
—Pediatric Primary:
Astrocytoma
Oral Cavity C2-C3 Squamous cell —buccinator, Rare TNM Associated with Plummer
carcinoma jugulodigastric, Vinson Syndrome & HPV
submandibular, and
submental nodes
Nasopharynx C1 Squamous cell —Cervical nodes —Cranial nerves TNM Associated with Epstein-
carcinoma —Retropharyngeal node —Bone Barr Virus
(node of Rouviere) —Lung
—Jugulodigastric —Liver
Oropharynx C2-C3 Squamous cell —Subdigastric Local invasion TNM
carcinoma —Upper cervical
—Submaxillary
—Parapharyngeal
Laryngopharynx C3-C6 Squamous cell —Midcervical nodes —Cranial nerves TNM Pyriform sinus is most
From hyoid carcinoma —Superior deep, middle —Nearby muscles common location
bone to and low jugular nodes
esophagus —Retropharyngeal node
(node of Rouviere)
, C3-C6 Squamous cell (Supraglottis) Supraclavicular TNM Associated with HPV &
Larynx carcinoma Jugulodigastric and nodes cigarette smoking
midjugular nodes
Salivary Glands Mucoepidermoid —Facial group —Cranial, facial TNM Parotid gland = most
carcinoma —Submandibular group nerves common to have cancer
—Extraglandular parotid —Arteries within the
group neck
(ipsilateral nodes)
—Papillary —Internal jugular chain —Bone TNM Possible treatment:
Thyroid —Mixed papillary- —Anterior cervical node —Lung Iodine-131
follicular (Delphian node) —Liver
—Follicular —Pretracheal —Brain
—Paratracheal nodes
Breast 2nd-6th rib Infiltrating ductal —Axillary Distant: TNM Most common site=UOQ
—Internal mammary —Bone Common chemo=CMF
—Supraclavicular —Lung
—Brain
—Liver
Lung —SCLC —Bronchopulmonary Local spread TNM SCLC = oat cell
—NSCLC —Hilar Distant: —Most aggressive
—Mesothelioma —Interlobar —Liver
—Mediastinal nodes —Brain
—Bones
—Bone marrow
—Adrenal glands
—Kidneys
—Cervical lymph
nodes
—Contra-lateral lung
Pathology
Brain —Metastatic None —Local invasion GTM
—Adult Primary: —CSF spread
glioblastoma
multiforme
—Pediatric Primary:
Astrocytoma
Oral Cavity C2-C3 Squamous cell —buccinator, Rare TNM Associated with Plummer
carcinoma jugulodigastric, Vinson Syndrome & HPV
submandibular, and
submental nodes
Nasopharynx C1 Squamous cell —Cervical nodes —Cranial nerves TNM Associated with Epstein-
carcinoma —Retropharyngeal node —Bone Barr Virus
(node of Rouviere) —Lung
—Jugulodigastric —Liver
Oropharynx C2-C3 Squamous cell —Subdigastric Local invasion TNM
carcinoma —Upper cervical
—Submaxillary
—Parapharyngeal
Laryngopharynx C3-C6 Squamous cell —Midcervical nodes —Cranial nerves TNM Pyriform sinus is most
From hyoid carcinoma —Superior deep, middle —Nearby muscles common location
bone to and low jugular nodes
esophagus —Retropharyngeal node
(node of Rouviere)
, C3-C6 Squamous cell (Supraglottis) Supraclavicular TNM Associated with HPV &
Larynx carcinoma Jugulodigastric and nodes cigarette smoking
midjugular nodes
Salivary Glands Mucoepidermoid —Facial group —Cranial, facial TNM Parotid gland = most
carcinoma —Submandibular group nerves common to have cancer
—Extraglandular parotid —Arteries within the
group neck
(ipsilateral nodes)
—Papillary —Internal jugular chain —Bone TNM Possible treatment:
Thyroid —Mixed papillary- —Anterior cervical node —Lung Iodine-131
follicular (Delphian node) —Liver
—Follicular —Pretracheal —Brain
—Paratracheal nodes
Breast 2nd-6th rib Infiltrating ductal —Axillary Distant: TNM Most common site=UOQ
—Internal mammary —Bone Common chemo=CMF
—Supraclavicular —Lung
—Brain
—Liver
Lung —SCLC —Bronchopulmonary Local spread TNM SCLC = oat cell
—NSCLC —Hilar Distant: —Most aggressive
—Mesothelioma —Interlobar —Liver
—Mediastinal nodes —Brain
—Bones
—Bone marrow
—Adrenal glands
—Kidneys
—Cervical lymph
nodes
—Contra-lateral lung
