One of the major determinants of treatment planning and prognosis of oral cancer is whether or not metastatic cervical lymph node involved before treatment. The criteria of cervical lymph node metastasis be performed by CT (computed tomography) and US (ultrasonography) was suggested. The criteria were as follows ;
1. Definitely or probably metastasis
2. Definitely or probably non-metastasis
3. Questionable
“Questionable”lymph node are often experienced in the clinic.
The purpose of this study was to examine those“questionable”lymph nodes and to evaluate the change of CT and US findings of cervical lymphadenopathy before and after preoperative chemoradiotherapy. Thirty-four cervical lymph nodes (13 metastasis, 21 non-metastasis), which could not be diagnosed whether or not metastasis using the diagnostic criteria of CT and US before preoperative chemoradiotherapy, were evaluated retrospec-tively. CT and US images before preoperative chemoradiotherapy were compared with those after preoperative chemoradiotherapy.
Metastatic lymph nodes increased internal echoes and/or decreased more than 4 mm in short diameter on US image by preoperative chemoradiotherapy.
It was considered that the change of US findings before and after preoperative chemoradiotherapy was useful for differentiating metastasis from non-metastasis.

View full abstract

The purpose of this study was to investigate the treatment of 190 cases of ameloblastoma from 1966 to 1994 of our department. The statistical results of age, sex and region were almost the same as those of other investigators. Thirty-five of 43 (81.4 %) cases underwent enucleation in the 1960s, but the 16 of 27 (59.3%) cases underwent partial resection of the mandible in the 1990s. The defect of mandible has been reconstructed by illiac bone grafting since 1968, but it has been grafted with a mixture of illiac bone and PCBM (particulate cancellous bone and marrow) since 1975. Grafting of the defect of inferior alveolar nerve with the great auricular nerve has been performed of out department since 1977. Recently, a pull-through technique of the inferior alveolar nerve bundle has been used at our department. If the reconstruction method of the mandible and nerve has been established, it would be possible to operate radically and positively. Relapse occurred in 17 cases after the first treatmen of enucleation. The first treatment of ameloblastoma is very important it is thought that the operation must be as radical as possible. It seems necessary to observe progress and perform follow-up in case of ameloblastoma for more than 10 years because, there was recurrence in one case 9 years 4 months after the first operation.
The fact that about 75% of the patirnts with amelo blastoma did not undergo follow-up is a problem requiring consideration.

View full abstract

The purpose of this study was to reveal the clinicopathological features and the background factors of multiple oral carcinomas. The studies of 12 multiple oral carcinoma patients with a total 36 foci, led to the following conclusions.
1) In terms of sex, siderations are observed more often with females (1 : 5) and their locations were most often on the buccal mucosa and the upper and lower gingivas. Many of them were the granulomatous type and manifested exophytic growth.
2) Second primary tumors were detected in their advanced stage comparatively, however, subseqent tumors were in their early stage. As the number of cancers multiplied, the sideration interval tended to be shortened.
3) As for the background factors, drinking and smoking habits were hardly involved. Rather, the presence of leukoplakia, erythroplakia, lichen planus, Plummer-Vinson syndrome in precancerous lesions and conditions were found to be the risk factors.

View full abstract

Sixteen patients with parotid gland tumors and 3 patients with submandibular gland tumors were evaluated by CT sialography. The 19 patients were 5 to 78 years old, mean age : 57. 3 years. CT sialography was performed preoperatively, and postoperative histological examination indicated that the tumors were benign in 13, a cyst in 1, malignant tumors in 4, and a malignant lymphoma in 1 patients. The tumorous lesion detection rate by CT sialography was 100%. The major duct was visualized in all pati-ents, and the examination was informative about the special relationship between the tumor and the facial nerve. No sign of malignancy was noted in an epithelial-myoepithelial carcinoma of 10 mm in diameter on CT sialography. In 2 patients adhesion to surrounding tissues observed intraoperatively was judged to be benign tumors by CT sialocaphy. The marcginal morphology of the tumor and the presence or absence of low density areas and punctate leakage in the interior of the tumor were useful for the judgment of malignancy of salivary gland tumors.
CT sialography, which provides diverse information on the location and morphology of the tumor, should be performed early for the diagnosis of salivary gland tumors.

View full abstract

Forty patients having squamous cell carcinoma of the upper alveolus and gingiva were analyzed clinicopathologically. These patients were treated radically at Second Department of Oral and Maxillof acial Surgery, Osaka Dental University, from 1980 to 1996. TNM classification of these cases was T1: 6, T2: 17, T3: 8, T4: 9, N0: 27, N1: 12, N2: 1, and M0 cases: 40. The results were as follows
1. Local control rate for T1, T2, T3 and T4 were 100%, 88%, 86% and 50%, and for anterior site, molar site and posterior site of primary involvement were 100%, 87% and 57% respectively.
2. Histologic metastasis to cervical lymph nodes were f ouod in 15 cases (37.5%), and secondary cervical metastasis in 5 cases of T3 and/or T4.
3. The cause of death was primary failure in 5 cases, neck lymph node failure in 5 cases and distant metastasis in 1 case.
4. Cases of T3, T4 and/or posterior site lesions showed poor prognosis.
5. High score group of histological malignancy grade showed poor prognosis conpared to low and moderate score group.
6. The cumulative 5-year survival rates for T1, T2, T3, T4 and all cases were 100%, 84%, 47%, 47% and 69% respectively.

View full abstract

A 68-year-old female had well differentiated squamous cell carcinoma of the left lingual edge (T3N0M0) . UFT-E granule was p. o. administered at a dose of 450mg/day from the first medical examination. The tumor had a tendency to reduce efficaciously. Furthermore, luecovorin tablets were p. o. administered together (30mg/day) in anticipation of tumor reduction for biochemical modulation 3 weeks later. The tumor clinically disappeared, and a partial glossectomy was achieved under general anesthesia. She wore full denture after discharge, and both functions of conversation and swallowing were good. She survived without tumor for 5 years and 2 months.

View full abstract

A case of thyroid cancer in a patient who had a squamous cell carcinoma of the tongue and had been treated by radiotherapy was reported. A 40-year-old female patient who had pain on the left rim of her tongue in early July 1997 was referred to our department on July 9, 1998. She had no facial change, and a significant lymph node was not palpable on the cervical lymph node. A 10mm×12mm non-identical, painful tumor with cementation was found on the left side of the back of the tongue. Pathologically the tumor was diagnosed as a squamous cell carcinoma (T₁N₀M₀) of the tongue by means of a tongue biopsy. Electron beam therapy was carried out three times (12Gy×3=36Gy) by the Department of Radiology and subsequently the lesion disappeared completely.
The progress of the patient was monitored and a tumor of 1 cm was found in the left thyroid upon palation of the cervical lymph node. The patient was referred to the Department of General Gastroenteriologic Surgery. The tumor was diagnosed as a papillary carcinoma by means of a cytological examination. CT showed a tumor of 1cm in diameter in the left lobe of the thyroid, but invasion around the tumor was not found. The thyroid left lobe was resected and conservative neck dissection was conducted under general anesthesia on October 13, 1998. The tumor was pathologically diagnosed as a papillary carcinoma. Progress has been good, with no recurrence in the oral and cervical regions.

View full abstract