The delayed appearance of occult cervical lymph node metastasis after long periods in patients with tongue squamous cell carcinoma: A report of three cases

Abstract

In oral cancer, occult cervical lymph node metastasis typically becomes apparent within two years from the initial treatment of the primary tumor. However, the clinical appearance of occult cervical lymph node metastasis rarely occurs more than two years from the initial treatment. We report three cases of cervical lymph node metastasis appearing more than two years later.
All three cases had cervical lymph node metastasis: it appeared in a 38-year old female patient two years and six months after brachytherapy for tongue squamous cell carcinoma; in a 47-year old female patient at five years and eleven months after partial glossectomy followed by brachytherapy for tongue squamous cell carcinoma; and in a 57-year old male patient at five years and eleven months after partial glossectomy for tongue squamous cell carcinoma. It is impossible to predict the time when occult cervical lymph node metastasis will clinically appear. In order to detect it as soon as possible, long-term careful follow-up and education for patients on cervical lymph node metastasis are required.