Document Detail

Metastatic cancer to the floor of mouth: the lingual lymph nodes.
MedLine Citation:
PMID:  11933183     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: The upper level of a cervical lymphadenectomy is anatomically defined at its anterior extent by the lower border of the mandible and, in surgical practice, by the lingual nerve. A neck dissection completed below this level is generally considered adequate for removal of lymph nodes at risk for metastases from oral cavity cancer. Traditional discontinuous neck dissections do not provide for removal of floor of mouth tissue along with the primary and neck specimens. METHODS: A case report presenting biopsies from a T2N2bM0 squamous cell carcinoma of the mobile tongue and adjacent floor of the mouth in a 73-year-old man. RESULTS: Deep biopsy of a ventral tongue and floor of mouth squamous cell carcinoma revealed occult metastatic cancer to lymph nodes located in the superficial floor of mouth associated with the sublingual gland above the lingual nerve. This report identifies floor of mouth lymph nodes that can be involved with cancer and missed through the standard practice of discontinuous neck dissection.Conclusions. This finding offers evidence that, in certain cases, a traditional discontinuous neck dissection may not address all lymph nodes at risk in the treatment of oral cavity cancer. Further investigation into lymph node distribution within the oral cavity is warranted to reappraise the upper limits of cervical lymphadenectomy.
Jay M Dutton; Scott M Graham; Henry T Hoffman
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Publication Detail:
Type:  Case Reports; Journal Article    
Journal Detail:
Title:  Head & neck     Volume:  24     ISSN:  1043-3074     ISO Abbreviation:  Head Neck     Publication Date:  2002 Apr 
Date Detail:
Created Date:  2002-04-04     Completed Date:  2002-05-02     Revised Date:  2006-10-05    
Medline Journal Info:
Nlm Unique ID:  8902541     Medline TA:  Head Neck     Country:  United States    
Other Details:
Languages:  eng     Pagination:  401-5     Citation Subset:  IM    
Copyright Information:
Copyright 2002 Wiley Periodicals, Inc.
Department of Otolaryngology and Bronchoesophagology, Rush Medical College, 1725 W. Harrison, Suite 340, Chicago, Illinois 60612, USA.
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MeSH Terms
Carcinoma, Squamous Cell / secondary,  surgery*
Lymph Node Excision*
Lymph Nodes / pathology,  surgery*
Lymphatic Metastasis
Mouth Floor / pathology,  surgery*
Mouth Neoplasms / secondary*,  surgery*
Neoplasms, Unknown Primary / pathology
Tongue Neoplasms / secondary,  surgery*
Comment In:
Head Neck. 2003 Apr;25(4):341-2; author reply 342   [PMID:  12658740 ]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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