Abstract
This article reported a 36-year male patient with tongue squamous cell carcinoma who showed negative cervical lymphadenopathy by clinical examination but cervical lymph node metastases diagnosed by pathological examination. The patient underwent tongue tumor resection and left forearm radial skin flap repair, and then received 50 Gy 3-D conformal radiotherapy and chemotherapy combining 5-fluorouracil with carboplatin. One year after the operation, although the patient showed no tumor recurrence in primary site and no metastasis of cervical lymph nodes, metastasis occurred in several tissues including spine, ribs, mandible, skeletal muscles of upper extremity as well as lymph nodes of the mediastinum and lung hilum, which caused the patient to die quickly. According to the literature, we conclude that distant metastasis of tongue squamous cell carcinoma was less common, but once it occurs, the prognosis of the patient is extremely poor.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Rao DN, Shroff PD, Chattopadhyay G, et al. Survival analysis of 5595 head and neck cancers — results of conventional treatment in a high-risk population. Br J Cancer, 1998, 77: 1514–1518.
Sano D, Myers JN. Metastasis of squamous cell carcinoma of the oral tongue. Cancer Metastasis Rev, 2007, 26: 645–662.
Hans S, Chauvet D, Sadoughi B, et al. Cardiac metastasis after squamous cell carcinoma of the base of tongue. Am J Otolaryngol, 2009, 30: 206–208.
Hardee PS, Hutchison IL. Intracranial metastases from oral squamous cell carcinoma. Br J Oral Maxillofac Surg, 2001, 39: 282–285.
Törnwall J, Snäll J, Mesimäki K. A rare case of spinal cord metastases from oral SCC. Br J Oral Maxillofac Surg, 2008, 46: 594–595.
Mess D, Songer M. Head and neck carcinoma metastases to the hand and foot. A case report of simultaneous involvement. Orthopedics, 1986, 9: 975–977.
Elkowitz SS, Patel M, Hirschfield LS. Paravertebral muscle metastases from primary tongue and nasopharyngeal carcinomas. Clin Radiol, 1991, 43: 400–401.
Yurut-Caloglu V, Caloglu M, Oz-Puyan F, et al. An unusual metastatic site of tongue carcinoma: shoulder muscles. Auris Nasus Larynx, 2008, 35: 443–446.
Dennington ML, Carter DR, Meyers AD. Distant metastases in head and neck epidermoid carcinoma. Laryngoscope, 1980, 90: 196–201.
Talmi YP, Cotlear D, Waller A, et al. Distant metastases in terminal head and neck cancer patients. J Laryngol Otol, 1997, 111: 454–458.
Vikram B, Strong EW, Shah JP, et al. Failure at distant sites following multimodality treatment for advanced head and neck cancer. Head Neck Surg, 1984, 6: 730–733.
Rodrigues VC, Moss SM, Tuomainen H. Oral cancer in the UK: to screen or not to screen. Oral Oncol, 1998, 34: 454–465.
Parkin DM, Pisani P, Ferlay J. Global cancer statistics. CA Cancer J Clin, 1999, 49: 33–64.
Silverman S Jr. Demographics and occurrence of oral and pharyngeal cancers. The outcomes, the trends, the challenge. J Am Dent Assoc, 2001, 132: 7S–11S.
Ho CM, Lam KH, Wei WI, et al. Occult lymph node metastasis in small oral tongue cancers. Head Neck, 1992, 14: 359–363.
Woolgar JA. Histological distribution of cervical lymph node metastases from intraoral/oropharyngeal squamous cell carcinomas. Br J Oral Maxillofac Surg, 1999, 37: 175–180.
Byers RM, Wolf PF, Ballantyne AJ. Rationale for elective modified neck dissection. Head Neck Surg, 1988, 10: 160–167.
Shah JP. Cervical lymph node metastases — diagnostic, therapeutic, and prognostic implications. Oncology (Williston Park), 1990, 4: 61–69.
Hughes CJ, Gallo O, Spiro RH, et al. Management of occult neck metastases in oral cavity squamous carcinoma. Am J Surg, 1993, 166: 380–383.
Spiro RH, Huvos AG, Wong GY, et al. Predictive value of tumor thickness in squamous carcinoma confined to the tongue and floor of the mouth. Am J Surg, 1986, 152: 345–350.
Leemans CR, Tiwari R, Nauta JJ, et al. Regional lymph node involvement and its significance in the development of distant metastases in head and neck carcinoma. Cancer, 1993, 71: 452–456.
Grandi C, Alloisio M, Moglia D, et al. Prognostic significance of lymphatic spread in head and neck carcinomas: therapeutic implications. Head Neck Surg, 1985, 8: 67–73.
Myers JN, Greenberg JS, Mo V, et al. Extracapsular spread. A significant predictor of treatment failure in patients with squamous cell carcinoma of the tongue. Cancer, 2001, 92: 3030–3036.
Johnson JT, Barnes EL, Myers EN, et al. The extracapsular spread of tumors in cervical node metastasis. Arch Otolaryngol, 1981, 107: 725–729.
Johnson JT, Myers EN, Bedetti CD, et al. Cervical lymph node metastases. Incidence and implications of extracapsular carcinoma. Arch Otolaryngol, 1985, 111: 534–537.
Greenberg JS, Fowler R, Gomez J, et al. Extent of extracapsular spread: a critical prognosticator in oral tongue cancer. Cancer, 2003, 97: 1464–1470.
Zbären P, Lehmann W. Frequency and sites of distant metastases in head and neck squamous cell carcinoma. An analysis of 101 cases at autopsy. Arch Otolaryngol Head Neck Surg, 1987, 113: 762–764.
Ferlito A, Shaha AR, Silver CE, et al. Incidence and sites of distant metastases from head and neck cancer. ORL J Otorhinolaryngol Relat Spec, 2001, 63: 202–207.
Calhoun KH, Fulmer P, Weiss R, et al. Distant metastases from head and neck squamous cell carcinomas. Laryngoscope, 1994, 104: 1199–1205.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Li, W., Zhang, L. & Huang, Y. Multiple distant metastasis of tongue squamous cell carcinoma after surgical operation and radiotherapy — a case report and literature review. Chin. -Ger. J. Clin. Oncol. 9, 669–673 (2010). https://doi.org/10.1007/s10330-010-0697-z
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10330-010-0697-z