METASTATIC MELANOMA TO RETROPHARYNGEAL LYMPH-NODES CAUSING PHARYNGEALOBSTRUCTION

The finding of melanoma that has metastasized to regional lymph nodes is prognostically unfavorable, Occasionally, lymph nodes beyond the re gional lymph node basin are the site of distant melanoma metastases. W e present the case of a patient with melanoma who developed nonregiona l lymph node metastases to retropharyngeal/parapharyngeal lymph nodes, resulting in symptoms of upper aerodigestive tract obstruction, Physi cal examination of the head and neck, fiberoptic examination, and CT s can were abnormal, The patient underwent unilateral transcervical lymp hadenectomy and resection of the obstructing retropharyngeal tumor mas s. A sternocleidomastoid muscle flap was used to augment the posterior pharyngeal wall closure. The patient was able to resume full oral int ake without need for a tracheostomy. Surgical intervention can play an important role in the palliation of selected patients with nonregiona l metastatic melanoma to the head and neck.