Purpose: To elucidate the imaging features of subsequent metastases to the in-transit lymph nodes in the floor of the mouth of patients with squamous cell carcinoma (SCC) of the tongue.
Materials and methods: From 1997 through 2007, five tongue SCC patients with mass lesions in the floor of the mouth suggesting subsequent metastases to the in-transit lymph nodes were shown on imaging studies, and enrolled in this retrospective study. The lesions were demonstrated initially by conscientious monthly repeated follow-up sonography, followed by post-contrast CT or MRI. We named lymph node metastases observed posterior to the sublingual space and medial to the submandibular gland as the “parasubmandibular node” metastases, and considered the nodes belonging to the in-transit lymph nodes the same as the lateral lingual nodes locating in the sublingual space.
Results: With regard to the comparison between preoperative images and histopathological specimens obtained by radical neck dissection on a one-to-one basis, it was speculated that two cases had lateral lingual node metastases, two cases had parasubmandibular node metastases and one case had both. In the same research period, the total numbers of patients having in-transit lymph node metastases in the floor of the mouth were seven, which accounted for 16.3% of 43 tongue SCC patients with histopathologically verified metastases to the cervical lymph nodes.
Conclusions: We deemed that the parasubmandibular nodes played a role as in-transit lymph nodes locating on a lymph drainage pathway from the tongue to the internal jugular nodes, the same as the lateral lingual nodes. Accurate anatomical knowledge and careful observation is needed to detect the subsequent metastases to the lateral lingual and/or parasubmandibular nodes on imaging studies during a follow-up period after treatment of the tongue SCC with N0 neck.

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The management of ameloblastoma still remains controversial. Principally, in cases where there was no or little perforation of the surrounding bone, we chose conservative surgical management that is an extirpation with peripheral osteotomy and cryotherapy of the internal bone surface. In this report the treatment histories of 50 cases of ameloblastoma, especially recurrent cases, from 1982 to 2007 at our department were investigated clinicostatistically.
Of the 50 cases, we performed extirpation on 12 cases, extirpation with peripheral osteotomy and/or cryotherapy (extirpation with assistant therapy) on 21 cases and dissection (marginal or partial dissection of the jaw) on 17 cases. The recurrence rate was 12% (6 of 50 cases). Five recurrent cases received extirpation (recurrence rate: 42%) and one case received extirpation with assistant therapy (recurrence rate: 6%). The dissection caused no recurrent cases. There was a significant difference between extirpation with and without assistant therapy in the recurrence rate as well as between extirpation and dissection.
These results suggested that the procedures of peripheral osteotomy and cryotherapy in conservative surgical management for ameloblastomas is useful for controlling the lesion.

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We report an advanced tongue cancer patient with chronic renal failure who underwent superselective intra-arterial chemoradiotherapy via the superficial temporal artery and occipital artery.
A 64-year-old woman with ulcer of the tongue was referred to our department. The patient had chronic renal failure, and has been undergoing dialysis three times a week. The mass measured 45 × 40mm and was elastic hard. An incisional biopsy revealed squamous cell carcinoma.
Super-selective intra-arterial chemotherapy using docetaxel (10mg/m²/week, total 50mg/m²) as well as cisplatin (5 mg/m²/day, total 125mg/m²) via the superficial temporal artery and occipital artery combined with daily concurrent radiotherapy (2 Gy/day, total 50Gy,) was employed for five weeks. The treatment course was uneventful and the patient has been free of disease for 16 months.
This method can be one of the effective treatments for oral cancer patients with chronic renal failure.

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