Metastases to the Rouviere nodes and headache.

This paper presents two cases of Rouviere node metastasis in carcinoma of the hypopharynx as confirmed by gallium scintigraphy. Invasion of the Rouviere nodes was clarified within six months of the onset of symptoms in both cases. One patient eventually died of intracranial cancerous invasion and the other remains in the terminal stage of cancer with multiple bone metastases. It was hitherto believed that metastases to the Rouviere nodes were extremely difficult to diagnose in the early stages. However, it is now apparent that the neurological signs and symptoms which commonly appear in patients with cancerous invasion of the jugular foramen syndrome facilitate early diagnosis of the disease, the most common symptom being a headache.