Cervical lymph node metastasis from a remote primary tumour site-A Diagnostic conundrum-Letter to Editor

Abstract

Cervical cancer is the most common genital tract malignancy among women, accounting for many deaths in developing countries like
India. . Most of the metastasis to neck nodes arise from primary tumors of the head andneck. 54 year old multiparous postmenopausal woman with a lump in left side of her neck. Ultrasound of the neck revealed multiple enlarged hypoechoic lymphnodes, FNAC showed carcinomatous deposits in the nodes. no pallor, icterus or pedal edema. PAP smear showed atypical cells arranged predominantly in clusters, few singly scaterred and occasional ones in vague acinar pattern. atypical cells have round oval nucleus, increase nuclear cytoplasic ration, hyperchroatic nuclei, irregular nuclear borders, nuclear overlapping with moderate amount of cytoplasm and tumour diasthesis which was interpretated as adenocarcinoma. The prognosis for metastatic carcinoma of the cervix is poor and metastases to the neck signals a grave prognosis.