Untitled

Abstract

Control of cervical lymph node metastases in oral cancer is very important as a prognostic factor. In case of invasion into surrounding tissues such as muscle, bone, mucosa and skin, extended radical neck dissection is necessary to avoid neck failure. We report a case of delayed cervical lymph node metastasis near the hyoid bone treated successfully by chemotherapy with TS-1 and thermoradiotherapy.A female in her 40' s with ulcer of the right tongue was referred to our department. The patient underwent right partial glossectomy. Six months after the surgery, an ipsilateral cervical lymph node metastasis near the hyoid bone was found. To avoid extended radical neck dissection including resection of the hyoid bone and pharyngeal mucosa, we performed chemotherapy with TS-1 (100 mg/day, total 2,800 mg) and thermoradiotherapy (2 Gy/day, total 40 Gy, RF capacitive hyperthermia : 4 times) as a preoperative treatment. The efficacy according to CT scan was classified as partial response. The patient underwent conservative neck dissection without extended surgery and pathological diagnosis of the metastatic lymph node was complete response. There was no recurrence of neck lymph node metastasis 13 months after the surgery.