Abstract
Metastasis to the lateral retropharyngeal lymph node, the so-called Rouviere node (RN), is rarely observed in carcinoma of the oral cavity, especially the tongue. The prognosis is extremely poor for those patients with metastasis to RN. Here we report a case of RN metastasis from squamous cell carcinoma of the tongue successfully treated with concurrent chemoradiotherapy (CCRT).
A 59-year-old man visited our facility with the complaint of contact pain of the tongue. A biopsy revealed that the lesion was squamous cell carcinoma (T2N1M0, stageⅢ). The patient underwent hemiglossectomy of the left side and selective neck dissection simultaneous with reconstruction using free radial forearm flap. Four months later, owing to the detection of a metastatic left submental lymph node, submental neck dissection of the left side and supraomohyoid neck dissection (SOHND) of the right side were performed. Postoperative concurrent chemoradiotherapy (CCRT) was initiated. The total dose of cisplatin was 200mg/m2, and irradiation was performed at 2Gy per fraction, for a total of 60Gy. However, after the irradiation of 8Gy, metastasis of the left side of RN was detected on CT and PET-CT. Radiotherapy including the RN lesion was continued. One month after the CCRT, RN was not detected by CT and PET-CT. The treatment effect was complete response. During follow-up for 29 months, there was neither recurrence in the oral cavity nor RN metastasis after the CCRT.
