Recurrent cervical lymphadenitis is a common clinical presentation often managed with empiric antibiotic therapy. However, despite antibiotic treatment, persistent lymphadenopathy warrants consideration of alternative etiologies, including malignancy. We present the case of a 71-year-old female with recurrent cervical lymphadenitis that initially responded to antibiotics but was ultimately diagnosed as lymphoma upon biopsy. Despite conservative management, the patient\'s symptoms persisted, prompting surgical excision of the lymph node. Histopathological examination confirmed the lymphoma diagnosis, highlighting the importance of considering malignancy in cases of persistent lymphadenitis. This case underscores the significance of prompt evaluation, including biopsy, to ensure timely diagnosis and appropriate management in patients with recurrent cervical lymphadenitis.

Sarcoidosis is a systemic inflammatory disease characterized by the formation of immune granulomas in multiple organs. The cause of this disease is not yet clear. Papillary thyroid cancer (PTC) is the most common malignant endocrine tumor and is often associated with cervical lymph node metastasis. Assessment of risk factors associated with a poor prognosis is crucial in PTC. The coexistence of sarcoidosis and thyroid cancer is rarely reported in the literature. We describe a case of a 54-year-old female diagnosed with PTC and asymptomatic cervical and thoracic hilar lymphadenopathy due to concurrent sarcoidosis. This case will remind clinicians to be aware of the multiple potential causes of lymphadenopathy and realize the importance of the differences in the features of neck lymphadenopathy in patients with suspected head and neck cancer. Overall, careful workup and pretreatment screening enabled us to provide the patient with the most suitable treatment modality and avoid total thyroidectomy.

Stage IV breast cancer is difficult to cure and is mainly treated with systemic therapy. However, when distant metastasis is oligometastatic, proactive treatment including local therapies for the primary lesion and distant metastases has been reported to improve prognosis. We encountered a patient who had left breast cancer with ipsilateral cervical lymph node metastases. The metastases were oligometastatic, and we treated them curatively. The patient was a female in her 50s who had been aware of a lump in the lower inner quadrant of the left breast for a few years. A biopsy was performed and left breast cancer was diagnosed pathologically. Radiological examination showed metastasis to ipsilateral axillary and cervical lymph nodes. The cervical lymph node metastases were oligometastatic, suggesting possible improvement in prognosis by multimodality treatment including local therapy. The multimodality treatment in this case comprised mastectomy with levels I and II axillary lymph node dissection, systemic therapy (including chemotherapy, endocrine therapy, and molecular targeted therapy), and postmastectomy radiation therapy. The left chest wall and left supraclavicular lymph node region were irradiated. Furthermore, following the postmastectomy radiation therapy, the cervical lymph node metastases were treated with radical radiation therapy. The cure was achieved, with recurrence-free status maintained for two years and four months after the completion of radiation therapy. This case suggests that, for breast cancer with oligometastatic involvement of cervical lymph nodes, locally treating these distant metastatic lesions with radical radiation therapy as part of multimodality treatment is beneficial.

We present a case of a patient with simultaneous cervical lymph node metastasis of papillary thyroid cancer (PTC) and cecum neuroendocrine tumor (NET). A 45-year-old male patient with the diagnosis of metastatic NET of the cecum underwent fine needle aspiration (FNA) of a positron emission tomography with 18F-fluorodeoxyglucose (18F-FDG PET) positive nodule in the left thyroid lobe. Due to FNA finding suspect of PTC, the patient underwent total thyroidectomy with central neck dissection. Histopathologic finding revealed PTC of the left thyroid lobe and small solitary lymph node PTC metastasis in the central neck region. Postoperative evaluation with neck ultrasound (US) revealed two enlarged suspected lymph nodes in cervical regions III and IV on the left side of the neck and the patient underwent FNA with measurement of thyroglobulin (Tg) in the aspirates. The FNA finding of the cervical lymph node in the region III revealed PTC metastasis with high Tg value in the aspirate, while FNA finding of the cervical lymph node in the region IV revealed NET metastasis with low Tg value in the aspirate. Postoperative serum Tg value was 17.75 µg/L and the patient underwent 5550 MBq iodine-131 (I-131) therapy. A year after I-131 therapy, follow-up neck US demonstrated complete cure of PTC cervical lymph node metastasis in the region III and stable in size NET cervical lymph node metastasis in the region IV. To our knowledge, this is the first report of simultaneous occurrence of cervical lymph node metastases of PTC and NET of the cecum.

We aimed at evaluating the impact of ultrasound-guided (US) hookwire localization of nonpalpable cervical lymphadenopathy on operating time.
Retrospective case control study (January 2017 and May 2021) of 26 patients with lateral nonpalpable cervical lymphadenopathy undergoing surgery with (H+) and without (H-) per operative US-guided hook-wire localization. Operative time (general anesthesiology onset, hookwire placement, end of surgery) and surgery-related adverse events data were collected.
Mean operative time was significantly shorter in H+ group versus H- group (26 ± 16 min vs. 43 ± 22 min) (p = 0.02). Histopathological diagnosis accuracy was 100% versus 94% (H+ vs. H-, p = 0.1). No significant between group difference in surgery-related adverse events was reported (wound healing, p = 0.162; hematomas, p = 0.498; neoplasms removal failure, p = 1).
US-guided hookwire localization of lateral nonpalpable cervical lymphadenopathy allowed a significant reduction in operative time, comparable histopathological diagnosis accuracy and adverse events compared with H-.

Although meningiomas are the most common central nervous system neoplasms, extracranial metastases are exceedingly rare. There are even fewer reports of metastatic meningiomas to the neck.
We described a patient with multiply recurrent orbital meningioma with metastasis to the neck found incidentally during neck exploration for composite resection and free tissue reconstruction. We performed a systematic review for all records pertaining to metastatic meningiomas to the cervical regions.
We found 9 previous reports of cervical metastatic meningiomas. Almost all cases underwent extensive local resection. There was no evidence of an association between the histological grade of the tumor and risk of metastasis to the neck. Cervical lymph node dissemination is more common in patients presenting after previous primary tumor resection.
In the context of a neck mass, our findings suggest that metastatic meningioma should be included in the differential diagnosis, especially in patients with previous resections.

We report a rare coexistence of tuberculosis and squamous cell carcinoma (SCC) of the same lymph node (LN). A 74-year-old woman with a swollen right cervix underwent computed tomography, which showed a nodule in the right lung and swollen LNs of the mediastinum and right supraclavicular fossa. She was diagnosed with LN tuberculosis; the puncture cytology of the clavicular LN was class IV. Anti-tuberculosis treatment was initiated. Her neck was compressed due to LN enlargement, and dyspnea appeared. A biopsy was performed to diagnose the SCC. We propose that malignancy should be considered if the patient has a narrowed airway due to an enlarged LN or if the response to tuberculosis treatment is poor.

Colorectal cancer (CRC) is the third most common cancer worldwide, and approximately 25% of patients already have metastases at the time of diagnosis. The most common metastatic sites for CRCs are the liver, lung, bone and brain and peritoneum. Cervical lymph node metastases in CRC are rare, particularly in the absence solid organ involvement. Here we present a case of a 73-year-old female patient who, following resection of a poorly differentiated caecal adenocarcinoma, re-presented four years later with a left level IV lymph node which was ultimately found to contain metastatic adenocarcinoma.

Basaloid squamous cell carcinoma (BSCC) is a variant of oral squamous cell carcinoma, is an aggressive, high grade variant and rare subtype of the head and neck SCC that less common in tonsils. Here, we are reporting a case of BSCC involving the tonsil with an extension on the cervical lymph node region.

Merkel cell carcinoma (MCC) is a rare, aggressive skin malignancy that has a propensity for local recurrence and metastasis to the lymph nodes. In this case report, we discuss a 54-year-old female with rheumatoid arthritis (RA) who had received treatment with prednisone (15 mg/day) for symptom relief and management. The patient visited our hospital with complaints of a nodule in right preauricular area. Computed tomography (CT) scans revealed no distant metastasis. The patient underwent surgical resection and histopathological evaluation of the nodule led to the diagnosis of MCC. The patients received post-surgical treatment with 6 MeV electronic wire radiotherapy. Six months later, CT of the head, neck, abdomen and chest demonstrated a right cervical lymph node mass at the C2 level. The patient then underwent cervical lymph node biopsy and pathological diagnosis confirmed metastatic MCC. One month after the lymph node biopsy, the patients received postoperative intensity modulated radiation therapy in the biopsied area. The patient did not experience any adverse effects to the therapy. In conclusion, the MCC patients with RA can tolerate radiation therapy. As MCC is a highly malignant neoplasia, considering the immune checkpoint inhibitors can lead to immune-related adverse events, detection of MCC at earlier stages is associated with better survival. The treatment decisions of MCC patients with RA continues is still challenging.