Oral Squamous Cell Carcinoma in Patients with Pulmonary Metastasis but no Locoregional Recurrences

• Published in: The Asian journal of oral and maxillofacial surgery Vol. 19; no. 4; pp. 197 - 202
• Main Authors: Yoshimura, Hitoshi, Yoshimura, Yasuro, Nariai, Yoshiki, Notsu, Kazuki, Mishima, Koichi, Maruyama, Riruke
• Format: Journal Article
• Language: English
• Published: Elsevier Ltd 01.12.2007
• Subjects: Carcinoma; clinical; local; Mouth neoplasms; Neoplasm metastasis; Neoplasm recurrence; Pathology; squamous cell; Pathology; Mouth neoplasms; clinical; Carcinoma; squamous cell; Neoplasm recurrence; Neoplasm metastasis; local
• ISSN: 0915-6992; 2212-1897
• DOI: 10.1016/S0915-6992(07)80003-3

Objective: This retrospective study aimed to clarify the clinicopathologicalfeatures of patients with oral squamous cell carcinoma that revealed pulmonary metastasis alone on first recognition of relapse and who died as a result of this pulmonary metastasis. Patients and Methods: This study comprised 6 patients with pulmonary and/or distant metastasis, but with no locoregional recurrences throughout their lives. These patients were selected from a base population of 104 oral squamous cell carcinoma patients. Results: Among the oral squamous cell carcinoma patients studied, 5.8% of patients (6/104) had previously experienced both primary and neck diseases. Histopathologically, the primary lesions were all well-differentiated squamous cell carcinomas. Pulmonary metastasis was most commonly observed in tongue cancer patients (67%; 4/6). Biopsy of the pulmonary metastatic lesion in 1 patient revealed moderately differentiated squamous cell carcinoma. Radical neck dissection with preservation of the internal jugular vein was done on 4 of the 6 patients. While no patient underwent radical salvage surgeries for pulmonary metastasis, all patients underwent palliative treatments, such as chemotherapy and radiotherapy, either alone or in combination. The study findings show that complete radical neck dissection was more effective than functional neck dissection. Conclusion: Six oral squamous cell carcinoma patients with pulmonary metastasis, but no locoregional recurrences, were analysed from the clinicopathological perspective, and a possible cause for the metastasis related to neck lymphatic and blood systems was identified.