Postoperative chemoradiotherapy with cisplatin in high-risk patients surgically treated for squamous cell carcinoma of the oral cavity was investigated. Of 17 patients studied, 13 patients completed the postoperative chemoradiotherapy, a completion rate of 76.5%. Grade 3 and more severe adverse reactions, as evaluated according to CTCAE Version 4.0, were leucopenia (5 patients), anemia (4), hypokalemia (3), inflammation of the oral mucosa (1), elevated serum creatinine (1), nausea (2), and anorexia (3). The completion rate of postoperative chemoradiotherapy seems to improve as experience with a given regimen accumulates; this therapy regimen was considered fully achievable as a standard therapy. We intend to review therapeutic outcomes in the accumulated cases. It should be possible to develop a new therapy through future studies that use this therapy as a control arm.

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Acinic cell carcinoma is a rare epithelial malignant tumor of the salivary gland categorized as a low-grade tumor. It commonly affects people in their 30s to 40s without sexual predominance. It is most commonly found in the parotid gland, and rarely found in the submandibular gland. We recently encountered a patient with acinic cell carcinoma of the submandibular gland exhibiting multiple hyperechoic spots on ultrasound, and describe this case here.
A 31-year-old woman presented with the chief complaint of left submandibular pain. Contrast-enhanced magnetic resonance imaging revealed a mass with a long axis of 9 mm in the left submandibular gland. Ultrasonography demonstrated a hypoechoic lesion with a long axis of 8 mm, containing multiple hyperechoic spots, each of which measured approximately 1 mm. Since the possibility of malignancy could not be ruled out, with a diagnosis of submandibular tumor, surgery for submandibular gland tumor resection was performed under general anesthesia in July 2010. The histopathological diagnosis was acinic cell carcinoma. The stroma of the tumor exhibited hyalinization, partially with calcification. The postoperative course was uneventful and the patient was discharged from the hospital one week after surgery. At present, after a postoperative follow-up of 19 months, the patient has no evidence of recurrence or metastasis.

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We report a case of lower gingival squamous cell carcinoma producing granulocyte colony-stimulating factor (G-CSF) of an 87-year-old woman. She was referred to our department with the chief complaint of a granulated mass in the right lower gingiva, which had persisted for 6 months. Pathological examination of a biopsy specimen revealed a moderately differentiated squamous cell carcinoma. Tumor resection was performed under general anesthesia. Two months post-operatively, lung metastasis of the tumor was observed, and laboratory findings showed marked leukocytosis. Lung metastasis tumor was diagnosed pathologically as a moderately differentiated squamous cell carcinoma. Immunohistochemical staining with monoclonal anti-G-CSF antibody was positive, so we diagnosed squamous cell carcinoma producing granulocyte colony-stimulating factor. Unfortunately, the patient expired 3 months post-operatively.

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