OBJECTIVETo investigate the characters of cervical lymph node metastases of primary tumors beyond head and neck.

METHODSAmong 466 cases of malignant tumor with cervical lymph node metastases treated in Peking Union Medical College Hospital from January 1989 to June 2004, 77 cases of tumor which sites primarily beyond head and neck were studied. Retrospective analysis of their clinical characters was done by LEVEL system.

RESULTSThe primary sites of these 77 cases of malignant tumor consisted of lung, stomach, esophagus, galactophore, colon, mediastinum, ovary, uterus, pancreas, liver, mesentery, adrenal gland and rectum. The frequency of cervical lymph node metastases was 81.8% (63/77) in LEVEL V (50 in the left), 11.7% (9/77) in LEVEL IV, 5.2% (4/77) in LEVEL III, 1.3% (1/77) in LEVEL I separately. The proportion of the metastases of malignant tumor from primary site beyond head and neck in each region was 2.1% in LEVEL I, 3.7% in LEVEL III, 14.3% in LEVEL IV, 70.8% in LEVEL V. Among the cervical lymph node metastases of primary tumor beyond head and neck, 51.9% were low-grade adenocarcinoma, 15.6% were medial-grade adenocarcinoma, 11.7% were low-grade squamous cell carcinoma, 10.4% were medial-grade squamous carcinoma.

CONCLUSIONSThe cervical lymph node metastases of malignant tumor might be seen from many organs beyond head and neck. The metastases from primary sites beyond head and neck usually focus on LEVEL V (81.8%), especially in the left. And the primary tumors beyond head and neck metastasis in this region were more than the tumors from head and neck locally. The histological type of the primary tumors were frequently low-medial grade carcinomas.