Left supraclavicular lymph node metastasis. There is persistent left level 4 lymphadenopathy, which measures 13 x 14 mm in axial cross-section. There is also a prominent left supraclavicular lymph node, which measures 7 x 11 mm in axial cross-section. The other cervical lymph nodes and other neck soft tissues are unremarkable. There is mild multilevel degenerative cervical spondylosis. The images portions of the intracranial structures and orbits are unremarkable.
Persistent left level 4 and supraclavicular lymphadenopathy with corresponding hypermetabolism on PET are compatible with metastatic disease.