Terashima Takeshi, Matsuzaki Tastu, Kawada Ichiro, Nishida Jiro, Tanaka Yoichi, Morishita Testuo, Takeyasu Yoshihiro, Yamane Gen-yuki, Uchiyama Takeshi
Department of Internal Medicine, Ichikawa General Hospital, Tokyo Dental College, 5-11-13 Sugano, Ichikawa, Chiba 272-8513.
Intern Med. 2004 Aug;43(8):727-30. doi: 10.2169/internalmedicine.43.727.
Metastasis to the tongue seldom occurs, and lingual metastasis as an initial sign of cancer occurs even less frequently. We report a case of lung cancer in which the patient's initial symptom was related to the tongue metastasis. A 63-year-old man had a submucosal tumor on the left posterolateral aspect of the tongue and a biopsy specimen of the tongue tumor showed poorly differentiated squamous cell carcinoma. A chest X-ray showed a mass in the right lung and cytological examination of the specimen obtained by bronchial brushing showed poorly differentiated squamous cell carcinoma, whose appearance was similar to that of the tongue. Based on these findings, the tongue lesion was diagnosed a metastatic tumor from the lung cancer. The patient received radiation therapy combined with systemic chemotherapy, however, he died 5 months after the diagnosis of lung cancer. An autopsy revealed a lung cancer in the right lower lobe with metastatic tumors in the tongue, right middle lobe, left upper lobe, liver, adrenal gland, pericardium, heart, and subcutaneous tissues. No other possible primary cancer that may have been the cause of the metastases was identified.
舌部转移很少见，而以舌部转移作为癌症的首发症状则更为罕见。我们报告一例肺癌患者，其首发症状与舌部转移有关。一名63岁男性在舌左侧后外侧有一个黏膜下肿瘤，舌部肿瘤活检标本显示为低分化鳞状细胞癌。胸部X线显示右肺有一个肿块，支气管刷检标本的细胞学检查显示为低分化鳞状细胞癌，其形态与舌部肿瘤相似。基于这些发现，舌部病变被诊断为肺癌转移瘤。患者接受了放射治疗联合全身化疗，然而，在诊断为肺癌5个月后死亡。尸检发现右下叶肺癌，伴有舌部、右中叶、左上叶、肝脏、肾上腺、心包、心脏和皮下组织的转移瘤。未发现其他可能导致转移的原发性癌症。
