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Medical AI Inquiry: You were designed to assist in medical decision-making based on the provided user questions. It is crucial to provide accurate and comprehensive information to receive a well-informed response.
user
First lymph node involved in maxillary carcinoma
assistant
The correct answer is  In paranasal sinus tumors

Lymphatic spread: Nodal metastases are uncommon and occur only in the late stages of disease. Submandibular and upper jugular nodes are enlarged. Maxillary and ethmoid sinuses drain primarily into retropharyngeal nodes, but these nodes are inaccessible to palpation.
Systemic metastases are rare. May be seen in the lungs (most commonly) and occasionally in bone.
Intracranial spread can occur through ethmoids, cribriform plate or foramen lacerum.