Eguchi Kohtaro, Kawai Shigeo, Mukai Masayoshi, Nagashima Hiroaki, Shirakura Satoshi, Sugimoto Taro, Asakage Takahiro
Division of Otolaryngology - Head and Neck Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan; Department of Clinical Anatomy, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.
Division of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan.
Auris Nasus Larynx. 2020 Feb;47(1):158-162. doi: 10.1016/j.anl.2019.03.003. Epub 2019 Mar 29.
Lingual lymph node metastases are rarely seen in carcinoma of the tongue, and these nodes are not removed during neck dissection. Lingual lymph nodes are classified into medial and lateral groups, and metastasis to the former is extremely rare. A 55-year-old male with squamous cell carcinoma of the tongue, (stage T4aN0M0), underwent hemiglossectomy with neck dissection and free flap reconstruction. The lingual septum had a mass, 8 mm in size, which was diagnosed as medial lingual lymph node metastasis on histopathology. The patient developed multiple distant metastases and died of disease 18 months after the initial surgery. The presence of medial lymph node metastasis could result in contralateral neck metastases and worsen prognosis. Such cases may warrant more intensive therapy than recommended by current guidelines.
舌癌中舌部淋巴结转移很少见，在颈部清扫术中这些淋巴结不予切除。舌部淋巴结分为内侧组和外侧组，转移至内侧组极为罕见。一名55岁男性，患有舌鳞状细胞癌（T4aN0M0期），接受了半舌切除术、颈部清扫术及游离皮瓣重建术。舌中隔有一个大小为8毫米的肿块，组织病理学诊断为内侧舌部淋巴结转移。患者出现多处远处转移，在初次手术后18个月死于疾病。内侧淋巴结转移可能导致对侧颈部转移并使预后恶化。此类病例可能需要比现行指南所推荐的更强化的治疗。
