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Protocolul terapeutic pentru metastazele limfoganglionare laterocervicale de carcinom spinocelular cu punct de plecare neprecizat. Source: Romanian Journal of Medical Practice. Identifi cation of subgroups with favorable prognosis is of decisive importance for the therapy of patients with CUP syndrome, including prolonged survival from directed treatment. The patients with neck node metastases from occult head and neck cancer have clinical features and cancer cervical lymph nodes similar to other head and neck malignancies.

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Case report: We report the case of a years-old female patient with personal history of cervical fistulizing tuberculous gumma diagnosed with right lateral cervical mass and Hashimoto nodular thyroiditis. The patient underwent to surgical treatment which consisted cancer cervical lymph nodes total thyroidectomy and modified neck dissection with resection of internal right jugular vein adherent to the lymph node mass. Results: The final pathology report demonstrated a pT3mN0LV1Pn0 right lobe papillary thyroid carcinoma on Hashimoto thyroiditis while lymph nodes presented giant epithelioid granulomas with giant multinuclear Langhans cells and central necrosis consistent with the diagnosis of tuberculous adenitis. The postoperative course was uneventful and the patient was referred to both TB and endocrinology specialist.

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Facing such a scenario, the only solution is following a sequence of investigations and therapy steps towards a correct and complete diagnosis if possible. We review the current literature data and present a personal case. There are many controversies regarding the primitive metastatic neck lymph nodes related to the optimum management, balanced with benefit for the patient. Keywords unknown, primary, metastatic, lymph, nodes Rezumat Metastazele primare de la nivelul ganglionilor cervicali sunt de­fi­nite în contextul cancer cervical lymph nodes tumori primare necunoscute de la ni­velul tractului respirator superior.

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Картинки были настолько отчетливы, что Николь казалось, будто она стоит вместе с Ричардом. И потому даже испугалась, когда новая последовательность воспоминаний перенесла ее к сцене прощания между Ричардом и его проводником-мирмикотом.

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Учитывая все случившееся с Николь, можно не сомневаться, что наши приятели с черно-золотыми щупальцами по-прежнему прячутся неподалеку. Но даже если они забросили свое старое логово, если нам все же придется перебираться туда, у нас возникнут те же проблемы с добыванием пищи. - А как насчет того, чтобы сходить за экран, дядя Ричард. - поинтересовался Патрик.

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А моя мама действительно была красавицей. - спросила Мария. - Видная женщина, это я помню, - ответила Николь, - хотя в такой-то темноте судить было трудновато.

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