Abstract
A case was reported of metastatic adenocarcinoma of the submandibular lymph node, in a 69 year old woman who was first treated for a maxillary gingival squamous cell carcinoma through partial resection of the upper jaw. After three months, swelling of the lymph node was observed on the same, right side as the maxillary gingival cancer, and an excisional biopsy was performed, revealing a metastatic adenocarcinoma. Extensive investigative procedures could not establish the cancer's primary site. A submandibular gland origin was suspected, and there for a radical neck dissection on the right side, and a submandibular neck dissection on the left side were performed, but did not reveal any cellular malignancy in either submandibular gland. After a further three months, a chest X-ray showed multiple opacities in the lungs, and a biopsy from the lung revealed a poorly differentiated adenocarcinoma. A similar tumor was also found in the stomach mucosa. The pathological findings were similar for the submandibular lymph node, lung, and stomach carcinomas. One year after the inception of her condition, the patient died. Diagnosis of the primary site of the adenocarcinoma of the submandibular lymph node was difficult until examination of the cancer in the patient's lungs confirmed those as the origin. It was established that the adenocarcinoma of the lung was a double cancer synchronous with S. C. C. of the maxillary gingiva.
