There have been various reports on studies of prognostic factors in oral cancer. ¹⁸F-Fluorodeoxyglucose positron emission tomography （¹⁸F-FDG PET） reveals the activity of glucose metabolism, and a qualitative evaluation is possible. ¹⁸F-FDG PET is already commonly used for staging. The aim of this study was to evaluate the prognosis and metabolic tumor factor of PET as an imaging biomarker.
Between January 2009 and December 2015, 154 patients were treated with oral squamous cell carcinoma and underwent PET/Computed Tomography （CT） in our department. No patients had previously undergone PET.
The subjects were 89 males and 65 females, with a mean age of 62.6. The most common primary site was the tongue. Locally advanced stage Ⅲ/Ⅳ accounted for the majority. The median follow-up period was 45.6 months.
Regarding the metabolic tumor factor of PET, standardized uptake values of SUVmax, SUVmean, Metabolic tumor volume （MTV）, Total lesion glycolysis （TLG） and SUVmax volume ratio （SVR） were 9.8, 5.9, 4126, 28809 and 4.9. Thresholds were set to 12.0, 6.7, 3000, 16000 and 4.8 as the result of Receiver Operating Characteristic curve （ROC） analysis. There were 128 and 26 patients with sphere and ring shaped types.
Three-year disease-free survival （3yDFS） was 80.2%, and 3y overall survival （OS） was 87.2%. By univariate analysis with prognosis, T, stage, high risk, SUVmax, SUVmean, MTV, TLG and uptake pattern were correlated in OS and DFS. In addition, by multivariate analysis, SUVmax and uptake pattern were correlated in OS and DFS.
The results showed that PET is useful as an imaging biomarker.

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The treatment of osteosarcoma arising in the jaw bone remains challenging. Neoadjuvant chemotherapy for osteosarcoma95J （NECO95J） is a treatment protocol developed and evaluated in Japan and its good efficacy has been reported. In this paper, we report a case of pathologically high-grade maxillary osteosarcoma treated according to the NECO95J protocol.
A 52-year-old man was referred to our hospital seeking treatment for swelling and pain on his left hard palate. Relatively well-circumscribed, elastic hard swelling （46×37mm） was observed on his left hard palate. Radiological assessment with computed tomography revealed a poorly-marginated amorphous mass including high and low density in the left hard palate extending to the left maxillary sinus. A biopsy was carried out and a histopathological diagnosis of osteosarcoma （chondroblastic type, high malignancy grade） was obtained.
The patient was treated according to multi-modal treatment including pre- and post-operative chemotherapy （NECO95J）. Firstly, the patient underwent induction chemotherapy of high-dose methotrexate, cisplatin, and doxorubicin. After radical resection of the tumor, high-dose ifosfamide （IFO） was added, because the induction chemotherapy was assessed as not effective. The patient experienced several severe adverse events, but the chemotherapy was almost accomplished as planned except for the last two doses of IFO. The patient showed no evidence of recurrence or metastasis during six years of follow-up.

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Oral metastasis in renal pelvic and ureteral cancer is very rare. We report a case of metastasis of renal pelvic and ureteral cancer to the mandibular condyle. A 70-year-old man was referred to our department because of pain in the right temporomandibular joint. Panoramic radiography showed a diffuse radiolucent lesion in the right mandibular condyle, then computed tomographic scans and magnetic resonance images revealed a poorly marginated mass lesion. The patient had been diagnosed earlier with left renal pelvic and ureteral cancer at the department of urology in our hospital. We performed an open biopsy of the right mandibular condyle, and urologists performed a left total nephroureterectomy to exclude a diagnosis of double cancer. Both pathological findings suggested that the oral lesion was metastatic squamous cell carcinoma from the renal pelvis. The patient received palliative chemotherapy, however, the primary tumor and generalized metastasis could not be controlled.

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Basal cell adenocarcinoma （BCAC） comprises approximately 2％ of malignant salivary gland tumors, of which more than 90％ occur in major salivary glands such as the parotid gland; those in the minor salivary glands are extremely rare. Here, we report a single case of basal cell adenocarcinoma originating in the soft palate and discuss and review the relevant literature.
A 65-year-old woman presented with a 12×10mm elastic slightly hard tumor in her left soft palate. The tumor was resected under general anesthesia. The resected tumor was spherical, elastic slightly hard, and covered by a thin capsule. Sectioning revealed a solid interior. A rapid intraoperative histopathological examination indicated monomorphic adenoma. Further histopathological examination of the resected specimen showed a tumor covered by a fibrous capsule formed by basal cell-like cells with an alveolar and papillary growth pattern and partial palisade arrangements at the alveolar margins. The tumor cell nuclei were oval shaped with minimal dyskaryosis, but infiltration and blood vessel invasion into the tumor capsule was observed. In addition, 4 mitotic images were observed in 10 enlarged magnifications, and Ki-67 LI was ＞10％. Based on these findings, the histopathological diagnosis was BCAC. Currently, progress is good and the patient is free of the disease.

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Bilateral chylothorax is a rare complication of radical neck dissection. We experienced a case of bilateral chylothorax after neck dissection on the left side.
A 54-year-old man with pain in the mandibular gingiva was referred to our hospital from a dental clinic on 28^th January 200X, and was diagnosed with squamous cell carcinoma of the left oral floor. Left radical neck dissection, right supraomohyoid neck dissection, marginal dissection of the left mandible, tumor resection of the left tongue and left oral floor, rectus abdominal free flap reconstruction, and tracheotomy were performed after preoperative chemoradiotherapy. On day 3 postoperatively, his oxygen saturation was remarkably decreased. Chest X-ray revealed bilateral pleural effusion. Pulmonary specialists were consulted and thoracic cavity drainage of the left side was performed. Biochemical analysis of the milky white effusion indicated bilateral chylothorax. On day 6 postoperatively, pleural effusion of the right thoracic cavity was increased, therefore a right thoracic drainage tube was inserted. A central venous catheter had been installed and total parenteral nutrition was initiated. Drainage from both sides of the chest decreased over the following week. As the volume of drainage fluid did not increase, the thoracic drainage tubes were removed 21 days after the operation. On day 22 postoperatively, medium-chain triglyceride diet was started. Over the five-year follow-up, the patient remains free from chylothorax.

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