A Patient with a Malignant Melanoma in the Left Temporal

A patient with a malignant melanoma in the left temporal region was told that because of the seriousness of the condition and the likelihood of metastases, an extensive operation was required including the removal of the deep cervical lymph nodes in the neck.
-Using your knowledge of anatomy, explain why it is necessary to remove the internal jugular vein in the neck as well as the deep cervical lymph nodes.

A) The deep cervical lymph nodes lie deep to the internal jugular vein, and it is necessary to remove the vein to get at the lymph nodes.
B) Damage to the internal jugular vein would result in serious air embolism.
C) The numerous tributaries of the internal jugular vein would complicate the procedure
D) The deep cervical lymph nodes are embedded in the carotid sheath and the tunica adventitia of the internal jugular vein.
E) Metastases of the melanoma commonly invade the internal jugular vein.