Treatment of recurrent tumor and radiation ulcer or necrosis after implantation of radium for 4 cases of tongue cancer

Abstract

Four patients suffering tongue cancers were discussed, concerning their clinical course after irradiation, using radium needling. Local control for primaly tumors remained during the time from 8 months to 9 years. Recurrent tumors appeared in the opposite side of the tongue at the 4 th year and in a buccal mucosa through mandibular ramus at 8 th months, which were in distant portions from the primary tumors. Therapeutic neck dissection for the cervical lymph metastases was carried out on two patients without prophylactic ones.
It was very difficult to differentiate the recurrent tumor from the radiation necrosis or the ulcer, because of the symptoms associated with induration and pain. Resection and reconstruction for 2 recurrent tumors and 2 radiation ulcers had successful results. However, the repeated biopsies for radiation necrosis which may develop into ulceration, should not be taken.