Heterotopic calcification in advanced cervical lymph nodes with metastasis from squamous cell carcinoma of the tongue: report of two cases

Introduction: We present a patient with carcinoma of the tongue with а lymph node and thyroid metastasеs. The squamous cell cancer of the tongue’s 5-year survival rate has not been improved in the last three decades. Most common sites of metastases are the locoregional lymph nodes, followed by distant pulmonary, liver, bone and skin metastasеs. Only ten cases of metastases to the thyroid gland are reported in the literature. Case report: A 79-year old man presented to the University Hospital in Varna, Bulgaria. Two months before admission, he noticed swelling of the tongue and progressive weight loss. The inspection of the oral cavity revealed a lesion on the left margin of the tongue. A biopsy was performed with a histological result of differentiated squamous cell carcinoma of the tongue. A computed tomography scan of the head and neck region discovered a lesion in the right thyroid lobe. 18-fluoro-2-deoxy-glucose-positron emission tomography imaging showed a metabolically active tumor of the tongue with hypermetabolic metastatic cervical lymph nodes and a zone with abnormally elevated fixation of 18F-FDG in the central part of the soft palate. The described thyroid nodule did not have an increased tracer uptake. It was cytologically assessed after fine-needle aspiration biopsy (FNAB) as a metastasis from squamous cell carcinoma of the tongue. Conclusions: Distant metastases from tongue cancer to the thyroid gland are extremely rare and mostly occur in the advanced stages of malignancy.

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Role of Clinical Palpation in Evaluation of Cervical Lymph Node in Oral Squamous Cell Carcinoma

Update Dental College Journal ◽

10.3329/updcj.v1i2.13978 ◽

2013 ◽

Vol 1 (2) ◽

pp. 02-06

Author(s):

SM Anwar Sadat ◽

Sufia Nasrin Rita ◽

Shoma Banik ◽

Md Nazmul Hasan Khandker ◽

Md Mahfuz Hossain ◽

...

Keyword(s):

Squamous Cell Carcinoma ◽

Lymph Node ◽

Oral Squamous Cell Carcinoma ◽

Lymph Nodes ◽

Cell Carcinoma ◽

Squamous Cell ◽

Predictive Value ◽

Cervical Lymph Node ◽

Betel Quid ◽

Cervical Lymph Nodes

A cross sectional study of 29 cases of oral squamous cell carcinoma with or without cervical lymph node metastasis was done among Bangladeshi patients from January 2006 to December 2007. Majority of the study subjects (34.5%) belonged to the age group of 40-49 years. 58.6% of the study subjects were male, while remaining 41.4% of them were female. 51.7% of the lesions were located in the alveolar ridge where the other common sites were buccal mucosa (27.6%) and retro molar area (13.8%). Half of the study subjects (51.7%) were habituated to betel quid chewing followed by 37.9% and 10.3% were habituated to smoking and betel quid-smoking respectively. Grade I lesions was most prevalent (75.9%) in the study subjects. Majority of cases presented with Stage IV lesions (55.2%). The sensitivity, specificity, positive predictive value, negative predictive value & accuracy of clinical palpation method for determining metastatic cervical lymph nodes were 93.33%, 64.29%, 73.68%, 90% and 79.3% respectively. Careful and repeated clinical palpation plays important role in evaluation of cervical lymph nodes though several modern techniques may help additionally in the management of oral cancer.DOI: http://dx.doi.org/10.3329/updcj.v1i2.13978 Update Dent. Coll. j. 2011: 1(2): 02-06

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