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Volume 19, Number 4, December 2007

Oral Squamous Cell Carcinoma in Patients with Pulmonary Metastasis but no Locoregional Recurrences

Hitoshi Yoshimura,1 Yasuro Yoshimura,1 Yoshiki Nariai,1 Kazuki Notsu,1 Koichi Mishima,1 Riruke Maruyama2
1Department of Oral and Maxillofacial Surgery, and 2Department of Laboratory Medicine, Faculty of Medicine, Shimane University, Shimane, Japan

Abstract
Objective:
This retrospective study aimed to clarify the clinicopathological features of patients with oral squamous cell carcinoma that revealed pulmonary metastasis alone on first recognition of relapse and who died as a result of this pulmonary metastasis.
Materials and Methods: This study comprised 6 patients with pulmonary and/or distant metastasis, but with no locoregional recurrences throughout their lives. These patients were selected from a base population of 104 oral squamous cell carcinoma patients.
Results: Among the oral squamous cell carcinoma patients studied, 5.8% of patients (6/104) had previously experienced both primary and neck diseases. Histopathologically, the primary lesions were all well-differentiated squamous cell carcinomas. Pulmonary metastasis was most commonly observed in tongue cancer patients (67%; 4/6). Biopsy of the pulmonary metastatic lesion in 1 patient revealed moderately differentiated squamous cell carcinoma. Radical neck dissection with preservation of the internal jugular vein was done on 4 of the 6 patients. While no patient underwent radical salvage surgeries for pulmonary metastasis, all patients underwent palliative treatments, such as chemotherapy and radiotherapy, either alone or in combination. The study findings show that complete radical neck dissection was more effective than functional neck dissection.
Conclusion: Six oral squamous cell carcinoma patients with pulmonary metastasis, but no locoregional recurrences, were analysed from the clinicopathological perspective, and a possible cause for the metastasis related to neck lymphatic and blood systems was identified.


Key words: Carcinoma, squamous cell, Mouth neoplasms, Neoplasm metastasis, Neoplasm recurrence, local, Pathology, clinica

Asian J Oral Maxillofac Surg. 2007;19:197-202.
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