Lymphadenopathy in Concurrent Head and Neck Malignancies

Second primary malignancies in the head and neck are a major cause of morbidity and mortality and include mucosal epithelial, hematologic, and cutaneous malignancies. Much is known about the imaging features of metastatic cervical lymphadenopathy in a single disease process; however, information on the imaging evaluation of cervical lymph nodes in the setting of multiple concurrent primary cancers is limited. Cancer multiplicity can make imaging evaluation challenging, but accurate interpretation is vital to appropriate workup and treatment. Here, we present four cases of concurrent head and neck malignancies with cervical lymphadenopathy and guidance on how to approach them with attention to lymph node location and morphologic abnormalities.