The relationship between mode of cervical lymph node metastasis and prognosis of 242 patients who underwent neck dissection (ND) with squamous cell carcinoma of the oral cavity from 1974 to 1993 were investigated. Three hundred NDs were performed and cervical lymph node metastases were histologically identified in 176 cases. The average of the metastatic nodes in the 176 pN (+) cases was 2.4, the extracapsular spread was seen in 62 cases (35%), and the spread of metastatic node was present as far as level III in 85%.
The rate of neck recurrence was 10.5 % in the pN (+) cases whose primary lesions had been controlled. The rate of distant metastasis was 23.5 % in the pN (+) cases whose primary and neck lesions had been controlled, and the incidence of distant metastasis was 41.7 % in patients who had more than 2 metastatic lymph nodes. The number and the level of metastatic lymph nodes were significantly related to the 5-year cumulative survival rate. Furthermore, as to cases whose primary and neck lesions had been controlled, the 5-year survival rate was 50.9 % and 50.5 % in patients who showed the metastatic lymph node of more than 2 and level N or V, respectively.
These result suggested that the postoperative strategy such as radiation therapy for the neck and/or adjuvant chemotherapy may be necessary to improve the prognosis of the patients who showed metastatic lymph nodes of more than 2 or level IV and/or V.

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Six cases of mucoepidermoid carcinoma of minor salivary gland were reported, and all the cases were primary. Three case of carcinomas originated in the hard palate, two originated in the buccal mucosa, and one originated in the lower gingiva. As a result of histological classification by W.H.O. (1991), three were well-differentiated type and three were poorly-differentiated type. Metastasis of cervical lymph node was observed in one of the cases of poorly-differentiated type. In five cases, surgery alone was carried out. In one case, the combination of surgery, chemotherapy, and radiotherapy was carried out. To date, no recurrence and metastasis has been noted, and all the cases have had good prognosis.

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Superselective intraarterial infusion of carboplatin with concurrent radiotherapy and tegafur, which was administered per os, was performed on two patients with advanced squamous cell carcinoma of the oral cavity. Seldinger's transfemoral technique was used, and the angiographic images of the external carotid artery were obtained. This was followed by a one-shot infusion of carboplatin into the vessels to feed the tumor.
Patient 1 with carcinoma of the tongue (T3N2bM0 stage IV) was treated with an intraarterial infusion of 700 mg carboplatin (450 mg for primary tumor, 250 mg for metastatic lymph nodes), an irradiation of 30 Gy, an 600 mg UFT per day. The patient showed complete response at the primary site, and there was no change in the metastatic lymph nodes. A histological examination of the resected specimens revealed no tumor cells at the primary site, but viable tumor cells were recognized in the lymph nodes.
Patient 2 with carcinoma of the buccal mucosa (T4N1M0 stage IV) was treated with an intraarterial infusion of 600 mg carboplatin, an irradiation of 60 Gy, and 400 mg UFT per day. The patient showed complete response both at the primary site and in the metastatic lymph node. Resection surgery was not performed.
Both patients showed no evidence of disease during the follow-up period of one year. As this method had a remarkable antitumor effect and slight adverse reactions, it was considered to be a good treatment method for advanced oral carcinomas. This method, however, needs special equipment and an experienced staff for arterial angiography, and its efficacy is unpredictable when an artery to feed the tumor is not found for a certainty.

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In the present paper, our experiences with rehabilitation of oral function and implant-supported dental prostheses in patients who had been treated for maxillary tumors are presented. The dental implants used in the present study were hydroxyapatite plasma-sprayed or flamesprayed titanium with an overlay denture-type superstructure. Masticatory and articulatory functions with implant-supported dental prostheses were examined in two cases.
The results of dental prescale and color-developing gum revealed lower levels of function than in normal subjects. Scores on Yamamoto's occlusion scale were 4 to 6. These results indicated that masticatory function was considerably improved. The results of speech intelligibility tests indicated that articulatory function was also considerably improved.
Our experiences strongly suggested that implant-supported dental prostheses are useful for the rehabilitation of masticatory and speech functions of maxillectomy patients.

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Desmoplastic fibroma of the jawbone is a rare tumor. A case of suspected desmoplastic fibroma in a 24-year-old female was observed.
Radiological examination revealed a poorly-circumscribed lesion, and spotty radiolucent appearances were noticed.
For treatment, a portion of the tumor was resected from 5 of the mandible.
Histopathological examination revealed that the tumor was composed of dense collagen fibers and fibroblasts.
The prognosis was fairly good after surgical treatment, and there are no signs of recurrence at present.

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Buccinator node, a facial lymph nodes lying on the Buccinator muscle, is rarely accompanied by carcinoma of the oral and maxillofacial regions. Only 10 metastatic diseases of the node diagnosed by imaging were described in the literature. In this report, two cases of metastases from oral and maxillary cancers was presented. Ore case was an 84-year-old female with squamous cell carcinoma (T2N1M0) . A polypoid tumorous lesion accompanied with submucosal induration was detected in the buccal region, and CT revealed another mass lesion with typical findings of metastatic lymph node situated deeply to the lesion. Another case was a 51-year-old male with squamous cell carcinoma of the maxillary sinus (T4N1M0) . CT and MR showed that the tumor had invaded severely into the subcutaneous layer and an another separate mass with typical findings of a metastatic lymph node situated in the buccal fat pad. In the literature, buccinator node metastases most frequently occurred in the facial node (50%) and were seldom accompanied by cervical node involvement (12%) . From the literatures reviewed including our cases, the most common primary sites to metastasize to the buccinator node may be buccal mucosa and maxillary sinus.
The results indicated that careful examinations, including cross-sectional imagings, would be required to assess the buccinator node in the cases of cancer in the buccal mucosa and maxillary sinus.

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Metastatic tumors in the oral and maxillofacial region are relatively infrequent. The common primary organs of neoplasm that metastasize to the jawbone are breast, lung and adrenal, in decreasing order of frequency. Therefore, metastasis of liver neoplasm to the mandible with aninitial symptom in the oral cavity is extremely rare. A case of metastatic hepatocellular carcinoma with the initial symptom of lower lip hypesthesia, was encountered and the clinical course is reported along with a review of the literatures of metastatic liver tumors of the mandible.
After consultation of the dentist, anesthesiologist, otorhinolaryngologist, and neurologist, the patient, a 59-year-old male, was referred to our clinic. Radiological findings of the bone adjacent to the first premolar of the mandible showed slightly diffuse absorption. The pathohistological findings of the biopsy specimen showed metastatic htaptocellular carci-noma of the mandible.
In case of metastatic liver neoplasm in the oral region, many reports indicated that the initial symptoms were swelling and bleeding. However, the literatures from 1957 to 1996 concerning metastatic hepatocellular carcinoma of the mandible revealed that 5 of 27 cases showed sensory disturbance of the trigeminal nerve. Furthermore, the most frequent age and sex were 50 years old and male, and the highest incidence was found in the body and ramus of the mandible.

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Adenolymphoma accounts for about 5% of all parotid gland tumors. This tumor grows slowly with no pain. The majority of this tumor appears unilaterally in the inferior pole of the superficial part of the parotid gland. Although very rare, around 7% of those tumors appear bilaterally. This is the particular character of adenolymphoma, since almost none of the other salivary gland tumors appears bilaterally. The following report describes a rare case of bilateral adenolymphoma of the parotid glands with 17-year interval.
A 51-year-old male was referred to our department in December 1979 because of swelling near the left parotid gland. On the first visit, although otherwise asymptomatic, a tumor of the size of the tip of a finger was found by palpation. Clinically, it appeared as a slow-growing, hard, nontender mass over the inferior pole of the parotid gland. The tumor, which was located at the inferior pole of the superficial part of the parotid gland with no adherence to the parotid gland, was surgically excised. Pathological examination revealed this lesion to be an adenolymphoma. Curiously, on January 1995, the same patient who had become 67 years old noticed a clinically similar mass over the inferior pole of the right parotid gland. CT scan revealed the mass on the right parotid gland without any invasive character. Therefore, the mass was surgically excised and revealed it to be an adenolymphoma again. The characters except the side difference was the same as the left Warthin's tumor.

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