Abstract
At our institute, recently, lateral retropharyngeal (LRP) node metastases were found in two patients with squamous cell carcinoma of the oral tongue. One case was a 35-year-old woman, who had previously received a local resection for a tongue carcinoma on the same side, and who visited with tongue pain. Intraoral examination indicated a T2N0 tongue SCC, and a partial glossectomy was performed. On postoperative CT images, a cervical node metastasis was seen, therefore, a functional neck dissection was performed. However, 1 month later, a metastatic LRP node was detected on CT. The other case was an 80-year-old woman who presented with contact pain of the tongue. Initial examination indicated a T4a tongue SCC. On CT, bilateral cervical node metastases were seen and the diagnosis was T4aN2cM0 tongue carcinoma; moreover, a metastatic LRP node was detected. We review these two cases and seven other cases with tongue cancer who developed LRP node metastasis reported in the Japanese literature. The distribution of TN classification was as follows: T1: 2, T2: 1, rT2: 1, T3: 2, T4: 2, unknown 1, and N0: 5, N1: 1, N2c: 2, unknown: 1. In all patients, LRP node metastases were detected on the same side as neck metastases. Almost all of the LRP node metastases were found within one year after the treatment of primary sites. LRP node metastases were controlled successfully only when surgical treatment was performed. Even in patients with tongue cancer, imaging diagnosis for early detection of LRP node metastasis should be considered, until extranodal invasion occurs, which may make surgical resection of metastatic LRP nodes and prevention of distant metastasis impossible.
