Maxillofacial Squamous Cell Carcinoma With Cervical Metastasis and Tuberculous Lymphadenitis - Diagnostic Dilemmas and Clinical Insights

Sep 29, 2026

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Maxillofacial squamous cell carcinoma (SCC) commonly spreads to lymph nodes, but concurrent tuberculous lymphadenitis is exceptionally rare and can mimic metastatic disease on imaging. The case involves a 68-year-old woman with right maxillofacial SCC and ipsilateral cervical lymphadenopathy. CT showed indeterminate nodes with rim enhancement and central necrosis. Surgical pathology of dissected nodes confirmed both metastatic SCC foci and tuberculous granulomas, with tuberculosis-specific tests returning positive results.

LanguageEnglish

CategoryHealthcare

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Pages6

Reading Time15 min

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Cancer Reports CASE REPORT OPEN ACCESS Maxillofacial Squamous Cell Carcinoma With Cervical Metastasis and Tuberculous Lymphadenitis: Diagnostic Dilemmas and Clinical Insights Xierzhati Tuerxun1 | Meiheriban Tuerhong1 | Zainure Wubulihasimu1 | Baihetiyaer Yimin1 | Maimaitituxun Tuerdi2 | Kai Liu1,3,4,5,6 1Department of Oral and Maxillofacial Surgery, Kashi Prefecture Second People's Hospital, Kashi, Xinjiang, China | 2Department of Oral and Maxillofacial Trauma and Orthognathic Surgery, The First Affiliated Hospital of Xinjiang Medical University, Urumqi, Xinjiang, China | 3Department of Oral and Craniomaxillofacial Surgery, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China | 4College of Stomatology, Shanghai Jiao Tong University, Shanghai, China | 5National Center for Stomatology, Shanghai, China | 6National Clinical Research Center for Oral Diseases; Shanghai Key Laboratory of Stomatology, Shanghai, China Correspondence: Maimaitituxun Tuerdi ([maimaitituxun@xjmu.edu.cn](maimaitituxun@xjmu.edu.cn); [maimaitituxun@aliyun.com](maimaitituxun@aliyun.com)) | Kai Liu ([kailiu20190103@163.com](kailiu20190103@163.com)) Received: 13 June 2025 | Revised: 16 November 2025 | Accepted: 24 December 2025 Keywords: coexisting pathology | diagnostic dilemma | neck dissection | squamous cell carcinoma | tuberculous lymphadenitis ABSTRACT Background: Maxillofacial squamous cell carcinoma (SCC) typically metastasizes to lymph nodes, yet coexisting tuberculous lymphadenitis is extraordinarily rare, posing diagnostic challenges. Case: A 68-year-old female with right maxillofacial SCC and ipsilateral lymphadenopathy underwent radical resection and selective neck dissection after computed tomography had shown nodes with central necrosis and rim enhancement—features indeterminate for metastasis versus infection. Histopathological examination of the dissected lymph nodes revealed concurrent metastatic SCC foci and tuberculous granulomas. Further tuberculosis-specific tests returned positive results, confirming the final diagnosis of metastatic maxillofacial SCC with coexisting tuberculous lymphadenitis. Notably, the patient had no tuberculosis-related symptoms, with tuberculous lymphadenitis unsuspected preoperatively, underscoring the diagnostic challenge of such coexisting conditions. Conclusions: This case highlights the importance of considering infectious comorbidities, particularly in cases with atypical imaging or clinical manifestations, when evaluating lymph node lesions in cancer patients to avoid misdiagnosis and optimize therapeutic strategies. 1 | Introduction Cutaneous squamous cell carcinoma (SCC) of the maxillofacial region is one of the most common malignant tumors with a high propensity for regional lymph node metastasis [1] . In this case, the patient presented with right facial SCC and ipsilateral cervical lymphadenopathy. Preoperative computed tomography (CT) imaging revealed lymph nodes with rim enhancement and central necrosis, initially suggestive of metastatic involvement. However, histopathological examination unexpectedly identified concurrent metastatic SCC foci and classic tuberculous lesions within the same regional lymph nodes. In clinical practice, the coexistence of regional lymph node metastasis and tuberculous lymphadenitis is exceedingly rare. Tuberculosis, a chronic granulomatous disease caused by | Xierzhati Tuerxun and Meiheriban Tuerhong contributed equally to this study. | | --- | | This is an open access article under the terms of the Creative Commons Attribution License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
© 2026 The Author(s). Cancer Reports published by Wiley Periodicals LLC. | Cancer Reports, 2026; 9:e70454 1 of 6 [https://doi.org/10.1002/cnr2.70454](https://doi.org/10.1002/cnr2.70454) Mycobacterium tuberculosis infection, typically resul

FAQs

Why is the diagnosis challenging in this case?

Metastatic SCC and tuberculous lymphadenitis can both present as painless cervical lymphadenopathy with overlapping CT features such as rim enhancement and central necrosis, leading to likely initial misdiagnosis as metastatic disease only.

What did the imaging suggest before surgery?

Computed tomography showed lymph nodes with central necrosis and rim enhancement, findings that were indeterminate and initially suggestive of metastatic involvement.

What confirmed the final diagnosis?

Histopathological examination of dissected lymph nodes revealed concurrent metastatic SCC foci and tuberculous granulomas, and tuberculosis-specific tests were positive, confirming metastatic maxillofacial SCC with coexisting tuberculous lymphadenitis.

Sep 29, 2026

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