Nonnodal, Nonspinal Metastatic Tumors to the Head and Neck: Distribution Pattern and Imaging Findings

Metastatic tumors to the head and neck from systemic malignancies usually occur in the lower cervical lymph nodes or cervical spine. Non-nodal and nonspinal metastasis in the extracranial head and neck is relatively uncommon. The purpose of this work was to find common locations and to describe the imaging features of metastatic tumors in the head and neck region. On the basis of our series of 34 metastatic lesions in 30 patients, the skeletal muscles, masticator space, parotid and thyroid glands, and orbit are potential sites of metastasis from systemic malignancies. Imaging characteristics of metastatic tumors to the head and neck are infiltrative margins and extension into adjacent structures with uncommon involvement of the cervical lymph nodes. The differential diagnosis should include sarcoma of the soft tissue, desmoids, lymphoma, and inflammatory pseudotumors. Knowledge of the clinical and imaging characteristics of these conditions is helpful, though biopsy is often necessary to make a definitive diagnosis.