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Article: Volume 48 Number 11 Page 942 - December 2021

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  Dental Update 495: 942-945

Oral and Maxillofacial Surgery:  A pain in the neck: cervical lymphadenopathy in metastatic disease

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Abstract: Cervical lymphadenopathy can serve as a silent progressive indicator of systemic pathology and metastatic disease. Incidental or asymptomatic cervical lymphadenopathy can present a clinical dilemma when deciding on appropriate referral pathways and in specialist investigations. Metastasis to the head and neck may be more easily identified than locating the primary tumour site, which often requires a multitude of investigations to achieve an accurate diagnosis. As highlighted in this case report, primary care dentists play a central role in identification of patients with cervical lymphadenopathy who may require urgent specialist input in the context of subclavicular disease.

Clinical relevance: This article highlights the clinical assessment of cervical lymphadenopathy and the investigatory tools used in secondary care to facilitate diagnosis.

Author notes: Jaspreet Virdee, BDS, MFDS RCSEd, Specialty Registrar Oral Surgery, Royal National ENT and Eastman Dental Hospitals, University College London Hospitals Trust, Roya Hazara, BDS MFDS, Specialty Doctor Oral and Maxillofacial Surgery; Michael Amin, BDS(Hons), FDSRCS(Eng), MBBS(Hons), FRCS(Eng), FRCS (OMFS) Consultant Oral and Maxillofacial Surgeon, Wexham Park Hospital, Slough. email: jaspreet.virdee@nhs.net

Objective: The reader should understand the important role of primary care dentists in assessing cervical lymphadenopathy, and the potential for subclavicular disease as a differential diagnosis.