Development or existence of non-metastatic lymph nodes in the previously operated neck: a good prognostic sign for oromaxillary squamous cell carcinoma?

We report a case of tongue carcinoma for which the pathological diagnosis reported no metastasis even though some images strongly indicated metastasis. A 60-year-old woman with a left tongue border ulcer was referred to our outpatient clinic. She had a 2×3mm ulcer with a whitish lesion on the left tongue border that contacted the lingual malposed left lower second premolar. We performed excisional biopsy and tooth extraction under general anesthesia. Pathological diagnosis showed differentiated squamous cell carcinoma with clear margins. After 4 years and 2 months, she developed lymphadenopathy in the left submandibular region. Contrast computed tomography (CT) images showed a 10 mm lymphadenopathy in the left submandibular region. Lymphadenopathy in the left submandibular and superior internal jugular regions was also detected by contrast magnetic resonance imaging. The lymphadenopathy was further identified by positron emission tomography-CT (PET-CT) , with average standardized uptake values (SUV) of 3.71 and 3.44, respectively. Because neck ultrasonography indicated a collapsed or constricted hilum of the lymph nodes, we diagnosed neck metastasis from tongue cancer as the lymphadenopathy. Under informed consent, we performed a left radical neck dissection ; 31 lymph nodes in the dissected tissue showed no cancer but rather lymphadenitis.

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Feasibility of the new TNM classification on the evaluation of progression degree of tongue squamous cell carcinomas

Yoshida

Kishimoto

Murase

et al. 2018

Journal of Japan Society for Oral Tumors

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The UICC TNM classification is based on criteria for evaluating the progress of oral cancer, and it was revised to the 8th edition in 2016. The depth of invasion (DOI) in T classification and the extra nodal extension (ENE) in N classification were newly introduced. In this study, 107 tongue squamous cell carcinoma cases who underwent surgery in our department were evaluated for TNM classification according to the 7th and 8th editions. We examined the relationship between TNM classification revision, cervical lymph node metastasis and survival rate. There were cT classification changes due to the revision of the TNM classification in 17 cases (15.9％) and pT classification changes in 6 cases (5.6％). The number of cases of cervical lymph node metastasis decreased in cT1 and pT1, and increased in cT2 and pT2. Two cases of cT4a and pT4a in the 7th edition were classified into cT3 and pT3 in the 8th edition, so the survival rate of cT3 and pT3 in the 8th edition was lower than in the 7th edition. Three cases of pN2b in the 7th edition were classified as pN3b in the 8th edition, and 3 cases were unhappy outcomes. This review of the TNM classification of our tongue squamous cell carcinoma cases from the 7th edition to the 8th edition led mainly to the rise of stage. The 8th edition TNM classification faithfully reflects the progress in cervical lymph node metastasis and survival rate, and is considered to be practical. Key words：UICC 8th TNM classification, tongue squamous cell carcinoma, depth of invasion, extra nodal extension

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Development or existence of non-metastatic lymph nodes in the previously operated neck: a good prognostic sign for oromaxillary squamous cell carcinoma?

Cited by 3 publications

References 13 publications

Lymph node detection by MRI before and after a systematic pelvic lymphadenectomy

Lymph node detection by MRI before and after a systematic pelvic lymphadenectomy

A case of tongue squamous cell carcinoma which pathological diagnosis had denied metastasis in spite of images had suspected metastasis strongly

Feasibility of the new TNM classification on the evaluation of progression degree of tongue squamous cell carcinomas

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