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Woods et al. J Cancer Metastasis Treat 2022;8:22 Journal of Cancer
DOI: 10.20517/2394-4722.2022.28
Metastasis and Treatment

Review Open Access

Lymph node metastasis from non-melanoma skin
cancer

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Robbie S. R. Woods , Jack F. C. Woods , Conall W. R. Fitzgerald , Ehab Alameer , Joseph Lopez ,
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Bhuvanesh Singh , Jatin P. Shah 1
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Department of Head & Neck Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
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Plastic & Reconstructive Surgery, Memorial Sloan Kettering Cancer Center, New York, NY 10065, USA.
Correspondence to: Dr. Jatin P. Shah, Department of Head & Neck Surgery, Memorial Sloan Kettering Cancer Center, New York,
NY 10065, USA. E-mail: shahj@mkscc.org
How to cite this article: Woods RSR, Woods JFC, Fitzgerald CWR, Alameer E, Lopez J, Singh B, Shah JP. Lymph node metastasis
from non-melanoma skin cancer. J Cancer Metastasis Treat 2022;8:22. https://dx.doi.org/10.20517/2394-4722.2022.28
Received: 28 Mar 2022 First Decision: 29 Apr 2022 Revised: 5 May 2022 Accepted: 23 May 2022 Published: 27 May 2022

Academic Editors: Luis Raez, Remco de Bree Copy Editor: Fangling Lan Production Editor: Fangling Lan

Abstract
The management of non-melanoma skin cancers metastatic to the neck is challenging due to variability in
biological behavior and patterns of regional lymphatic spread. Metastatic non-melanoma skin cancers to the
parotid and neck often behave aggressively, with a high incidence of local recurrence after treatment and reduced
five-year survival outcomes. Patterns of lymphatic spread are different from those seen in mucosal squamous cell
carcinoma, with higher prevalence of disease in the parotid and superficial lymphatics. These factors require that
treatment is individualized to achieve optimal outcomes. Traditionally, the management of non-melanoma skin
cancers metastatic to lymph nodes has involved surgical excision followed by adjuvant radiation therapy. However,
novel systemic therapies are showing promising results and their role in the management of these cancers is
evolving.

Keywords: Neck, non-melanoma cutaneous malignancy, skin neoplasms, lymph nodes, lymphatic metastasis

INTRODUCTION
Patterns of spread
In contrast to mucosal origin malignancies which predominantly metastasize to lymph nodes in levels I-V
in the neck (shown in Figure 1), cutaneous malignancies of the head and neck can also metastasize to the

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