頸部再発に対し放射線併用超選択的動注化学療法が奏効した舌扁平上皮癌の1例

Abstract

The prognosis of patients with cervical recurrence of oral squamous cell carcinoma after neck dissection is extremely poor because additional surgical resection is difficult owing to anatomical factors. In this report, we describe a case of cervical recurrence of tongue squamous cell carcinoma that was clinically eliminated by superselective intra-arterial chemotherapy with concurrent radiotherapy. The patient was a man in his forties who underwent a partial glossectomy for the treatment of tongue cancer of the left side （T2N0M0）. The histopathological diagnosis was moderately differentiated squamous cell carcinoma. On follow-up examination 9 months after the operation, computed tomography and ultrasonographic examination revealed cervical lymph node metastasis on the left side. Modified radical neck dissection of the left side was thus performed. One metastatic lymph node with extracapsular spread was pathologically found in the specimen. Two months after the neck dissection, a metastatic lymph node in the right submandibular region and neck recurrence on the left side were diagnosed. Two cycles of superselective intra-arterial chemotherapy with concurrent radiotherapy were delivered by the Seldinger technique via the femoral artery. The lesions were clinically eliminated after these treatments. There has been no evidence of recurrence or metastasis as of 6 years after therapy.