We report a case of metastases from pulmonary adenocarcinoma detected by a total neck dissection specimen for mandibular gingival carcinoma.
A 69-year-old man with discomfort in the left mandibular gingiva was referred to our hospital. A granular mass (30 × 23 mm) was located in his left mandibular gingiva. A pressure type of panoramic radiography absorption image was observed in the left mandibular bone. Lymph node metastases were detected in the left submandibular region by CT, US and MRI. CT also revealed an abnormal shadow in the right lung field, which was possibly due to inflammation. A clinical diagnosis of squamous cell carcinoma of the left mandibular gingiva (T2N2bM0) was made, and left total neck dissection and marginal resection of the left mandibular bone were performed. Metastases of pulmonary adenocarcinoma were detected in 13 lymph nodes at levels III, IV, and VB in the total neck dissection specimen. Subsequent treatments for pulmonary adenocarcinoma carried out at the Respiratory Medicine Department included radiation and chemotherapy.
