Opportunities for the treatment of elderly patients with oral cancer have increased with the ageing of society. A clinical study was conducted of the treatment of 24 oral cancer patients aged 80 years or older. Twenty-four patients were referred to our hospital; they were over 80 years old between July 2013 and June 2016. We researched their treatment and quality of life （QOL） retrospectively. The treatments were 17 cases of radical treatment, 1 case of palliative treatment, and 6 cases of best supporting care （BSC）. Radical resection was performed in 11 patients with local excision only, and local resection and surgery including neck dissection were performed in 6 patients. Among them, there were 3 cases of skin flap reconstruction, and the patients could maintain their QOL. 　In considering surgical selection criteria for elderly patients with oral cancer, there is G8, which is a functional evaluation of the elderly. In this study, the average score of the radical resection group was 12.3, that of the non-radical treatment group was 6.4, and that of flap reconstruction cases was 14.3.

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Metastasis to the lateral retropharyngeal lymph node, the so-called Rouviere lymph node （RLN）, is relatively common in patients with carcinoma of the nasopharynx, but is rare in patients with oral cavity carcinomas, especially of the tongue. We describe a case of RLN metastasis from a tongue carcinoma, successfully treated with radiotherapy plus cetuximab （bioradiotherapy: BRT）.
A 36-year-old woman visited our hospital with complaints of headache, nasal obstruction, and dysphagia. She had undergone radiotherapy and surgery for carcinoma of the tongue in a general hospital, and was then referred for chemotherapy and palliative therapy because of RLN metastasis.
However, the metastatic lesion progressed despite combination chemotherapy with cisplatin, 5-fluorouracil, and docetaxel （TPF）. BRT showed a survival benefit compared with radiotherapy alone for locally advanced squamous cell carcinoma of the head and neck. BRT was therefore performed, with complete response. There was no recurrence after BRT during a 4-year follow-up period.

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Pyoderma gangrenosum （PG） is an uncommon rapid progressive and ulcerating skin disease of unknown etiology. The early lesion shows a clinical feature similar to postoperative infection, so the diagnosis of PG is difficult. In this report, we present a rare case of PG arising after surgery for oral cancer.
A 72-year-old woman received radical resection for lower gingival cancer with reconstruction using delto-pectoral flap （D-P flap）. Six days after the surgery, she had pyrexia and water diarrhea. The submandibular skin around the insertion site of the D-P flap became reddish with diffuse swelling, pus discharge and severe tenderness. A provisional diagnosis was postoperative infection of the wound. Although the patient was given repeated courses of antibiotics, debridement and drainage, the lesion extended to the whole neck of the affected side and a necrotic ulcer with bluish-purple undermined borders surrounded by erythema was observed 13 days after the surgery. The patient was referred to a dermatologist and PG was strongly suspected. From the postoperative 15^th day, treatment with prednisolone and minocycline over the next several days improved her symptoms dramatically. Histopathological examination revealed that severe inflammatory cells, predominantly of neutrophils, had infiltrated into the dermis without bacterial components. These clinical and histopathological findings fulfilled the diagnostic criteria of PG.
PG should be taken into consideration as a potential complication in oral and maxillofacial surgery too.

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We report a case of tongue cancer that was treated by bolus injection from anastomotic branches after obstruction of the tumor-feeding arteries during retrograde super-selective intra-arterial chemoradiotherapy （IA-CRT）.
A 43-year-old woman was referred to our clinic in July 2012 and diagnosed with left tongue cancer with bilateral cervical lymph node metastases （T4aN2cM0, SCC）. We planned to treat the primary tumor with IA-CRT and neck lesion with neck dissection after IA-CRT. We inserted catheters from the superficial temporal artery （STA） to the common trunk of the lingual artery （LA） and facial artery （FA） in the affected side, and from STA to LA in the unaffected side. Regular examination with indigocarmine staining was done to check the positions of the catheters. After 46Gy radiation, the feeding area of LA and FA in the affected side was not stained with indigocarmine. Contrast study in the external carotid artery with Seldinger’s method revealed that LA and FA in the affected side were obstructed and anastomotic branches of FA existed in the buccal artery （BA） and inferior alveolar artery （IAA）, which are branches of the maxillary artery. IAA was embolized with a coil, and bolus injection from BA of cisplatin was given. Radiation therapy was completed in October 2012. Bilateral neck dissection was performed in November 2012. The patient has been free of recurrence and metastasis for 5 years.

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