Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan; Department of Dentistry and Oral-Maxillofacial Surgery, Ishioka Daiichi Hospital, Ibaraki, Japan.
Department of Oral and Maxillofacial Surgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Int J Oral Maxillofac Surg. 2023 Dec;52(12):1221-1224. doi: 10.1016/j.ijom.2023.07.001. Epub 2023 Aug 12.
Generally, systemic chemotherapy is indicated for oral squamous cell carcinoma with distant metastasis and has a poor prognosis. Recently, the advent of molecular targeted drugs, such as cetuximab and immune checkpoint inhibitors, has dramatically improved prognosis, though controlling distant metastasis remains challenging. We report a case of tongue cancer in which lung metastases disappeared in the long term. A 60-year-old Japanese male with squamous cell carcinoma of the tongue underwent preoperative chemoradiotherapy and surgery including subtotal glossectomy, bilateral modified radical neck dissection, and immediate reconstruction with an anterolateral thigh flap. One month after surgery, multiple nodules less than 10 mm in diameter appeared in both lungs on CT imaging. Multiple lung metastases were diagnosed with no local recurrence or regional lymph node metastasis. The patient continues to receive a 4-week treatment course of chemotherapy that included cetuximab every 3 months and the lung metastases were markedly reduced in size or had disappeared. No local recurrence or newly emerged metastases were observed. The patient has been doing well for nine years since the appearance of the lung metastases.
一般来说，对于发生远处转移的口腔鳞状细胞癌，全身化疗是指征，但预后较差。近年来，随着西妥昔单抗和免疫检查点抑制剂等分子靶向药物的出现，预后得到了显著改善，尽管控制远处转移仍然具有挑战性。我们报告了一例长期以来肺部转移灶消失的舌癌病例。一名 60 岁的日本男性患有舌部鳞状细胞癌，接受了术前放化疗以及手术治疗，包括部分舌切除术、双侧改良根治性颈淋巴结清扫术，以及股前外侧皮瓣即刻重建。手术后 1 个月，CT 成像显示双肺出现多个直径小于 10 毫米的结节。诊断为多发性肺转移，无局部复发或区域淋巴结转移。该患者继续接受每 3 个月接受一次西妥昔单抗的 4 周化疗疗程，肺转移灶的大小明显缩小或已消失。未观察到局部复发或新出现的转移灶。自出现肺部转移灶以来，该患者已无病生存 9 年。
