Medial lingual lymph node metastasis in carcinoma of the tongue

Kohtaro Eguchi; Shigeo Kawai; Masayoshi Mukai; Hiroaki Nagashima; Satoshi Shirakura; Taro Sugimoto; Takahiro Asakage

doi:10.1016/j.anl.2019.03.003

Medial lingual lymph node metastasis in carcinoma of the tongue

Auris Nasus Larynx. 2020 Feb;47(1):158-162. doi: 10.1016/j.anl.2019.03.003. Epub 2019 Mar 29.

Authors

Kohtaro Eguchi¹, Shigeo Kawai², Masayoshi Mukai³, Hiroaki Nagashima³, Satoshi Shirakura³, Taro Sugimoto³, Takahiro Asakage⁴

Affiliations

¹ 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. Electronic address: kohtaro.eguchi@gmail.com.
² Division of Pathology, Tokyo Metropolitan Cancer and Infectious Disease Center Komagome Hospital, Tokyo, Japan.
³ Division of Otolaryngology - Head and Neck Surgery, Tokyo Metropolitan Cancer and Infectious Diseases Center Komagome Hospital, Tokyo, Japan.
⁴ Department of Head and Neck Surgery, Tokyo Medical and Dental University Graduate School, Tokyo, Japan.

PMID: 30929928
DOI: 10.1016/j.anl.2019.03.003

Abstract

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.

Keywords: Cancer; Lingual carcinoma; Lingual lymph nodes; Lymph node metastasis; Medial lingual nodes.

Publication types

Case Reports

MeSH terms

Disease Progression
Free Tissue Flaps
Glossectomy
Humans
Liver Neoplasms / secondary
Lung Neoplasms / secondary
Lymph Nodes / diagnostic imaging
Lymph Nodes / pathology*
Lymph Nodes / surgery
Lymphatic Metastasis
Male
Middle Aged
Neck Dissection
Neoplasm Recurrence, Local / pathology
Plastic Surgery Procedures
Spinal Neoplasms / secondary
Squamous Cell Carcinoma of Head and Neck / diagnostic imaging
Squamous Cell Carcinoma of Head and Neck / pathology*
Squamous Cell Carcinoma of Head and Neck / secondary
Squamous Cell Carcinoma of Head and Neck / surgery
Tomography, X-Ray Computed
Tongue
Tongue Neoplasms / diagnostic imaging
Tongue Neoplasms / pathology*
Tongue Neoplasms / surgery
Ultrasonography