Manabu Okamoto

Metastasis to the linguallymph node in carcinoma of the tongue

Lingual lymph nodes are occasionally found along the course of some lymph-vessels of the tongue. However, their existence has received little attention and metastasis of carcinoma of the tongue to them has not previously been reported. Three cases of carcinoma of the tongue with metastasis to the lingual lymph node are described and a discussion of the importance of such metastasis in the treatment of carcinoma of the tongue is presented.

Cervical Lymph Node Metastasis in Carcinoma of the Tongue Correlation between Clinical and Histopathological Findings and Metastasis

The factors relating to lymph node metastasis occurring in association with carcinoma of the tongue have been investigated clinically and histopathologically by many authors. Nevertheless, accuracy in predicting lymph node metastasis has not yet been attained. The present study describes the results of analysis performed in an attempt to predict lymph node metastasis of carcinoma of the tongue. Ninety-eight patients with squamous cell carcinoma of the tongue who were treated at our institution were investigated. Among the 98 patients, lymph node metastases were histologically proven after neck dissection in 40 patients. For statistical analysis in the present study, the quantification theory Type II of Hayashi (1954) was employed for discriminatory analysis. According to this discriminatory analysis, the correlations between the clinical (age, tumour size, N-category) and histopathological (degree of keratinization, mitoses, structure, mode of invasion) findings and metastasis were assessed on the basis of the partial correlation coefficients; these coefficients for each finding were not greatly different from each other and 74 out of 98 patients (76%) could be differentiated between patients with metastasis and without metastasis accurately. The prediction of lymph node metastasis by such discriminatory analysis had significant validity.

Late occurring recurrence of oral cancer after combined treatment with bleomycin and radiotherapy

Among 11 patients with oral cancer that disappeared after combined treatment with bleomycin and radiotherapy without surgery, one had an early recurrence and three had recurrences after 2 years or more. These late occurring recurrences were microcancers on mucous membranes that were thought to have been cured. Two of the three patients whose tumors recurred and another patient were found to have epithelial dysplasia at 1 year and 2 months, 4 years and 2 months, and 1 year and 3 months later, respectively. Among 59 patients who underwent surgery after the combined treatment, no viable cancer cells were found in the resected specimens of 20 patients, but moderate or severe epithelial dysplasia was noted in ten of the 20 patients. The present findings imply that patients in whom an apparent cure has been brought about by conservative treatment may harbor latent malignancy.