Journal of Japanese Society of Oral Oncology

The lateral retropharyngeal node (LRPN) is located in the posterior pharynx space which surrounds the internal carotid artery and prevertebral muscle. LRPN is commonly referred to as the Rouviere lymph nodes. LRPN metastasis often occurs from pharyngeal cancer, but seldom occurs from oral cancer. Oral cancers invading the pharynx sometimes metastasize to LRPN, but the prognosis of those with LRPN metastasis is extremely poor because there is no appropriate treatment for LRPN metastasis. We experienced two patients with oral squamous cell carcinoma which had metastasized to LRPN in spite of no remarkable posterior invasion. One of the two patients underwent parapharyngeal dissection, and one has remained disease-free for 7 years. The mechanism of LRPN metastasis of oral cancer without posterior invasion and the usefulness of parapharyngeal dissection are evaluated.

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We report a case of adenosquamous carcinoma arising in the left side of the tongue. An 80-year-old man was referred to our hospital due to a painless tumor with ulcer in the left side of the tongue. Clinical examination showed an elastic hard mass measuring 30 × 30 mm in size. MRI revealed a well-defined mass in the left side of the tongue, of low intensity on T1-weighted images and moderate intensity on T2-weighted images. An incisional biopsy was carried out and revealed cancer, although the detailed histological diagnosis was unclear. MRI, CT, echo and FDG-PET did not show metastasis in cervical lymph nodes or other organs. Hemiglossectomy, supra-omohyoid neck dissection with reconstruction using a radial forearm flap was carried out. Histopathological examination of the surgical specimen showed adenosquamous carcinoma with two metastatic cervical lymph nodes. There has been no sign of recurrence or metastasis for 1 year, 4 months postoperatively.

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