2023 Volume 69 Issue 5 Pages 260-265
We report a case of Virchow (node) metastasis of cervical cancer concurrently with mandibular gingival cancer. A 58-year-old woman was referred to our department complaining of inflammation and pain in her right mandibular gingiva. A histopathological diagnosis of mandibular gingival squamous cell carcinoma (SCC) was obtained by biopsy. FDG-PET/CT showed significant accumulation in the cervix and left supraclavicular lymph node, suggesting the possibility of cervical malignancy. No cervical malignancy was found by a gynecological examination, so we performed marginal mandibulectomy and resected the lymph node. Histopathological examination of the lymph node revealed metastasis of the SCC. Postoperative gynecological examination also found no cervical cancer. However, we couldn’t exclude the possibility of distant metastasis of cervical cancer, so we performed postoperative chemotherapy with docetaxel, cisplatin and 5 -fluorouracil based on the gynecologist’s recommendation. The cervical cancer was confirmed six months after the chemotherapy. As immunohistochemical analysis revealed positive staining for p16 in the cervical cancer and metastatic lymph node but not in the oral cancer, we diagnosed the metastasis as Virchow metastasis of cervical cancer. The patient subsequently underwent chemoradiotherapy for the treatment of cervical cancer. As of eight years and nine months from the first visit, there has been no recurrence of oral or cervical cancer.
