Precise surgical resection of tongue cancer requires information about the area of tumor extension preoperatively. Tongue cancer was measured in vivo and in fresh surgical specimens using ultrasonography. There was no difference in the extension of the tumor between the two on ultrasonography. However, there was a significant difference in the extension of the tongue cancer between the in vivo ultrasonogram and the pathological specimen (p < 0.05). However, the extension of the tumor on the in vivo ultrasonogram was significantly correlated with the extension on histological examination of specimens stained with hematoxylin and eosin (p < 0.01). Furthermore, on regression analysis, the extension of the tumor on histological examination could be predicted precisely from the in vivo ultrasonogram (R-square, 0.52-0.88). Thus, ultrasonic examination to determine tumor extension appears to be helpful as a preoperative examination to plan surgery in patients with tongue cancer.

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A clinicopathological study was performed on 12 (6 men, 6 women; mean age, 59.3 years) patients with mucoepidermoid carcinoma of the salivary gland treated in our department between 1995 and 2010. According to the Goode histopathological grading system, 8 cases were considered as low grade and 4 cases were considered as high grade.
As for the relationship between histopathological grading and age, no significant difference was found between mean age of patients with low-grade tumors (mean age, 55.1) and that of patients with high-grade tumors (mean age, 67.5). With regard to sex, low-grade tumors were common in women, whereas high-grade tumors were common in men.
Assessment of cervical lymph node metastasis revealed that many patients with low-grade tumors were N0, and those with high-grade tumors were N1-3. In relation to clinical staging, low-grade tumors were mostly stage I, whereas high-grade tumors were mostly stage IVA. The local control rate for patients with low-grade tumors was 75.0%, which is significantly lower than the 25.0% for patients with high-grade tumors. The 5-year cause-specific survival rate for patients with high-grade tumors was 25.0%, which is significantly lower than the 87.5% for patients with low-grade tumors. The 5-year disease-free survival rate was also significantly lower in patients with high-grade tumors, with 22.0% compared to 72.9% for patients with low-grade tumors.
These results suggest that the Goode histopathological grading system could be useful for prognostic prediction of mucoepidermoid carcinoma.

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Keratocystic odontogenic tumor (KCOT) is a benign intraosseous tumor with a lining of parakeratinized stratified squamous epithelium. The most important clinical feature of KCOT is its tendency to recur after surgical treatment.
In this study, we examined 63 KCOTs treated at the Department of Oral and Maxillofacial Surgery, Nagano Red Cross Hospital from 1983 to 2010. The mean age of patients was 40 years old and there was no sexual distinction. The angle of the mandible, extending anteriorly and superiorly, was the most frequently involved region. Enucleation was performed for 59 primary tumors, and 10 recurrences were noted. No recurrence was noted in 2 lesions managed by enucleation after marsupialization, 1 lesion managed by marginal mandibulectomy, and 1 lesion managed by segmental mandibulectomy. In total, the recurrence rate was 15.9%. Many of the recurrences were found at the margins of the primary lesion in contact with the roots of teeth. The average interval until recurrence was 4 years 3 months.
Our findings indicate that more aggressive treatment is needed for KCOTs as compared with other cystic lesions and long-term follow-up is required in patients with KCOTs.

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Although reconstruction surgery has advanced, a dento-maxillary prosthesis is still applied in many cases of maxillary defect after surgery for a malignant maxillary tumor. There are dento-maxillary prostheses with hollow and buccal flange obturators, but these have some disadvantages, such as miscellaneous germ growth due to retained immersion solution and the distortion and resonance of phonation.
Stereolithography is capable of preparing a stereoscopic model with the same morphology as the actual object within a short period by applying CAD/CAM technology to 3-dimensional image data, such as CT data, and it has recently been used in clinical practice. However, model preparation is expensive and time-consuming.
We prepared an inflatable balloon maxillary prosthesis from a 3-dimensional lamination molding model utilizing ink-jet printing, instead of the current stereolithography, applied it to a patient with a maxillary defect, and achieved a favorable outcome.

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At our institute, recently, lateral retropharyngeal (LRP) node metastases were found in two patients with squamous cell carcinoma of the oral tongue. One case was a 35-year-old woman, who had previously received a local resection for a tongue carcinoma on the same side, and who visited with tongue pain. Intraoral examination indicated a T2N0 tongue SCC, and a partial glossectomy was performed. On postoperative CT images, a cervical node metastasis was seen, therefore, a functional neck dissection was performed. However, 1 month later, a metastatic LRP node was detected on CT. The other case was an 80-year-old woman who presented with contact pain of the tongue. Initial examination indicated a T4a tongue SCC. On CT, bilateral cervical node metastases were seen and the diagnosis was T4aN2cM0 tongue carcinoma; moreover, a metastatic LRP node was detected. We review these two cases and seven other cases with tongue cancer who developed LRP node metastasis reported in the Japanese literature. The distribution of TN classification was as follows: T1: 2, T2: 1, rT2: 1, T3: 2, T4: 2, unknown 1, and N0: 5, N1: 1, N2c: 2, unknown: 1. In all patients, LRP node metastases were detected on the same side as neck metastases. Almost all of the LRP node metastases were found within one year after the treatment of primary sites. LRP node metastases were controlled successfully only when surgical treatment was performed. Even in patients with tongue cancer, imaging diagnosis for early detection of LRP node metastasis should be considered, until extranodal invasion occurs, which may make surgical resection of metastatic LRP nodes and prevention of distant metastasis impossible.

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Forestier's disease is a degenerative form of arthritis which causes spinal stiffness by ossification and thickening of the anterior longitudinal ligament. Management of the difficult airway and dysphagia is a major concern in the case of cervical vertebrae involvement. We report a case of squamous cell carcinoma of the tongue with Forestier's disease. A 69-year-old man was referred to our hospital because of a painful mass in the right margin of the tongue in mid March 2008. Intraoral examination revealed a granuloma-like mass, enlarged to 22 × 18 × 10mm in diameter, in the right margin of the tongue. CT images showed hyperostosis of the cervical vertebrae which caused tracheal deviation and airway narrowing. Partial glossectomy was performed under general anesthesia, following tracheotomy in order to prevent airway obstruction and pulmonary aspiration during the postoperative period. The postoperative course was uneventful and no evidence of pulmonary aspiration was found. During follow-up for 48 months, the patient has remained free of recurrence and metastasis, and dysphagia with progression of Forestier's disease has not been noted.

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