Table 1.

Detailed data of the patients in the study

No.	Age (years)	Sex	History	Physical examination	Primary disease	H&N metastasis region	Systemic metastases	Treatment modality	Prognosis
1	61	M	Nephrectomy and retroperitoneal lymph node dissection 20 years ago	Tender and hemorrhagic mass on the free end of the tongue for 2 months	Renal cell carcinoma (clear cell variant) PAX-8 (+)	Tongue	No	Partial glossectomy + radiotherapy	Patient died 8 months after surgery due to systemic disease
2	58	M	Hemicolectomy+ partial liver resection 9 months before	Newly formed hemorrhagic mass on the lateral side of the tongue	Colon adenocarcinoma p-ANCA and CDX2 (+)	Tongue	Lungs, neck, intra-abdominal lymph nodes	Palliative chemotherapy	Patient is alive at 3 months after diagnosis
3	48	F	Left-sided modified radical mastectomy and axillary node clearance for breast cancer 14 years ago. Presented with hoarseness, cough, and swelling on the neck for several months	A 25×20 mm solid, non-tender mass at the level 4 of the left neck Left vocal fold paralysis MRI showed a dense homogeneous mass that surrounded the common carotid artery 360°	Breast ductal carcinoma metastases ER 80% PR 90% Cerb-B2 positivity in 20% HER-2 (+)	Left neck, level 4	Left subpectoral area	Radiotherapy to the neck and systemic Trastuzumab therapy	Patient was alive, and the disease was under control at 18 months of follow-up*
4	64	F	Bilateral salpingo-oophorectomy +total abdominal hysterectomy 2 years ago	Solid, immobile and painless mass at the level 3 of the right neck for 2 months	Ovarian serous adenocarcinoma PAX-8 (+) Wt 1 (+)	Right neck, level 3	No	Functional neck dissection+ adjuvant radiotherapy	Patient was alive and free of disease at 2 years of control
5	72	F	Patient, receiving chemotherapy for an inoperable ovarian carcinoma	A firm, painless and immobile solid mass was palpated at the level 4 of the left neck	Ovarian serous adenocarcinoma (FNAB) PAX-8 (+) Wt 1 (+)	Left neck, level 4	Diffuse metastases to intraperitoneal lymph nodes, peritoneum, bowels, and neck	Palliative chemotherapy	Patient died 1 month after diagnosis
6	52	F	Modified radical mastectomy and axillary node clearance 2 years ago. Presented with lesion and skin retraction on the right cheek	A deep retraction was present on the right cheek. The lesion was extending to the oral mucosa and invading the base of the right maxillary sinus	Lobular breast cancer ER 90% PR 90% Cerb-B2 positivity in 10% HER-2 (+)	Right cheek, buccal mucosa, and maxillary sinus	No	En-bloc tumor resection with radical neck dissection+ trastuzumab therapy	Patient was alive and free of disease at 18 months of control
7	88	M	No known history of any other malignant diseases. Presented with hoarseness for 1 month	A subglottic, polypoid mass and erythroplakia on the right vocal cord was observed	Undifferentiated carcinoma** Focal PAP (+)	Larynx, subglottis, and right vocal fold	No	Total laryngectomy was not planned due to advanced age. Patient was referred to the oncology clinic for palliative chemotherapy	Patient was still alive at 20 months of follow-up. Disease was at remission. Subglottic lesion regressed with chemotherapy
8	77	M	Chemotherapy for lung adenocarcinoma 6 months prior to parotid gland swelling	Painless swelling at the right parotid gland	Lung adenocarcinoma TTF-1 (+)	Parotid gland	No	Radiotherapy for the primary tumor and chemoradiotherapy for parotid metastases	Patient died 4 months after biopsy was performed from the parotid gland
9	72	M	Radical prostatectomy 3 years ago, under hormonotherapy	PET-CT scan revealed high 18-FDG uptake at the nasopharynx. Endoscopic examination revealed a solid mass at the right Rosenmuller fossa	Prostatic adenocarcinoma PAP (+) PAS (+)	Nasopharynx	Multiple bone metastases	Palliative chemotherapy	Patient was alive at 1 month of control
10	64	M	Radical prostatectomy 8 years ago + chemotherapy	A solid, immobile and painless mass at the level 3 of the right neck was present	Prostatic adenocarcinoma PAP (+) PAS (+)	Right neck, level 3	No	Right radical neck dissection + chemotherapy	Patient died 2 years after surgery
11	79	M	Presented with a solid mass at the thyroid gland. No known history of any other malignant disease	A 4×3.7 cm solid mass was present at the inferior part of the right thyroid lobe	Lung adenocarcinoma TTF-1 (+) Cytokeratin-7 (+)	Thyroid gland	Bilateral neck, axilla, intra-abdominal, iliac lymph chains	Referred to the Thorax Surgery department for primary disease. Radiotherapy for the neck	No follow-up data are present

PAX-8: paired box gene-8; p-ANCA: Perinuclear Anti-Neutrophil Cytoplasmic Antibodies; ER: estrogen receptor; PR: progesteron receptor; HER-2: human epidermal growth factor receptor-2; Wt-1: Wilms tumor-1; PAP: prostatic acid prostatic acid phosphatase; TTF-1: thyroid transcription factor-1; PAS: periodic acid-schiff