Palliation of dysphagia with radiotherapy for exophytic base tongue metastases in a case of renal cell carcinoma

• Published in: Indian journal of urology Vol. 27; no. 4; pp. 550 - 552
• Main Authors: Wadasadawala, Tabassum, Kumar, Prabhash, Agarwal, Jaiprakash, Ghosh-Laskar, Sarbani
• Format: Journal Article
• Language: English
• Published: India Medknow Publications and Media Pvt. Ltd 01.10.2011; Medknow Publications & Media Pvt. Ltd; Medknow Publications & Media Pvt Ltd; Wolters Kluwer Medknow Publications
• Subjects: Base tongue; Carcinoma, Renal cell; Care and treatment; Case Report; Case studies; Deglutition disorders; Development and progression; Diagnosis; Health aspects; Kidney cancer; metastases; Metastasis; palliative radiotherapy; Radiation therapy; Radiotherapy; renal cell carcinoma; Risk factors; Tongue; India; metastases; renal cell carcinoma; Base tongue; palliative radiotherapy
• ISSN: 0970-1591; 1998-3824; 1998-3824
• DOI: 10.4103/0970-1591.91452

Base tongue involvement is a rare presentation of lingual metastases from renal cell carcinoma. A 48-year-old gentleman was treated with open radical nephrectomy and adjuvant radiotherapy for Stage II Furhman grade I clear cell carcinoma of the left kidney at an outside hospital. He presented metachronously 5 years later with progressive dysphagia and change of voice. Clinicoradiological evaluation revealed a large exophytic mass in the oropharynx with epicenter in the right base of tongue. Metastatic workup revealed widespread dissemination to multiple organs and bone. In view of predominant symptom of dysphagia, base tongue metastasis was treated with protracted course of palliative radiotherapy to a dose of 50 Gy in conventional fractionation over 5 weeks. This resulted in excellent and durable response at the base tongue lesion (till the time of last follow-up). Radiation therapy is an acceptable palliative strategy for advanced lingual metastasis as it produces prompt relief of pain, bleeding, and dysphagia.