Vol.99 No.2 contentsPRACTICA OTO-RHINO-LARYNGOLOGICA
Vol. 99 No. 2 February 2006
Early Stage Oral Cancer Patients with
Occurrence of Distant Metastasis
Hideki Chijiwa, Youko Takane, Yoshihisa Ueda,
Yoshimi Miyajima and Tadashi Nakashima
(Kurume University School of Medicine)
In general, the early stage of oral cancer shows a good prognosis. It is widely accepted that distant metastasis to distant organ does not occur without metastasis to the cervical lymph nodes. We encountered two cases of early oral cancer who developed distant metastasis to the lung without any evidence of metastasis to the neck lymph nodes. The first case was a 63-year-old woman diagnosed as having T1 oral cancer. Resection of the tumor was performed using a CO2 laser, but lung metastasis was detected five months later. Systemic chemotherapy with CDDP, 5-Fu was administered and complete response was obtained. The patient has not shown any sign of recurrence to date. The second case was a 48-year-old man who was diagnosed as having T1 oral cancer. Surgical removal of the tumor was performed with CO2 laser. Although the postoperative course of the primary site is uneventful, lung metastasis was detected only four months after. Combined systemic chemotherapy with TXT, CDDP and 5-Fu was administered along with hypo-fractionated stereotactic radiotherapy to the metastatic lung cancer. Partial response was obtained and at present, adjuvant chemotherapy with TS-1 is being continued. Histopathologic study of the resected primary tumor was again performed, and a vessel invasion or a skip cancer lesion was recognized. Minute histopathologic observation of the primary tumor as well as positive postoperative treatment against distant metastasis are now underway.
Key words : early oral cancer, distant metastasis, treatment, histopathology