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Metastatic lesions of tongue

 Department of Pathology, Sri Devaraj Urs Medical College, Kolar, Karnataka, India

Date of Submission06-Jun-2020
Date of Decision09-Jul-2020
Date of Acceptance20-Jul-2020

Correspondence Address:
Subhashish Das,
Flat No: 5, Officers Quarters, Sri Devaraj Urs Medical College, Tamaka, Kolar, Karnataka
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/mjdrdypu.mjdrdypu_314_20

How to cite this URL:
Das S. Metastatic lesions of tongue. Med J DY Patil Vidyapeeth [Epub ahead of print] [cited 2021 May 10]. Available from: https://www.mjdrdypv.org/preprintarticle.asp?id=308980

One of the common sites of oral cancer is tongue and accounts for 2% of all cancer deaths. Patients usually present at a mean age of 61.1 years, and there is a 1.5:1 male-to-female ratio. Approximately half of the cancers were diagnosed at an advanced stage and most of them involve the base of the tongue.[1]

Approximately 5%–10% of all cancer patients develop spinal metastasis; however, vertebral metastases are rare forms of distant metastasis from squamous cell carcinoma (SCC) of the oral cavity. Persistent back or neck pain should alert the surgeon, which warrants a detailed radiological examination in such patients.[2]

Lee et al.[3] reported two cases of lumbar vertebral metastasis from the SCC of the tongue. One case of delayed metastasis to the C3 vertebral body from primary adenoid cystic carcinoma of the tongue was reported by Feng et al.[4] Metastasis to cervical vertebrae from oral SCC has also been reported by Carlson and Ord in 4 patients (0.7%) of 597 patients in their series.[2] Although metastasis to the spine is usually extradural, intramedullary metastasis has also been reported by Törnwall et al.[5] in one case.

It is very well known that if metastatic vertebral disease is left untreated, it may lead to paraplegia, which is one of the most serious complications of metastasis. Harrington described a classification guideline system based on both bone destruction and neurologic impairment and distinguishes five classes of vertebral metastatic lesions and suggested surgical intervention for Class IV and V lesions.[6]

The prognosis for metastatic spine disease is dependent on several factors. Patients with single-level involvement have a better survival rate (average survival, 12.9 months) than patients with multiple-level involvement (average, 7.9 months). Age can also be considered as a prognostic factor for survival because patients younger than 60 years survive significantly longer than older patients (20.1 vs. 6.2 months; P = 0.028).[7] The 5-year disease-specific survival rates for Stage IV disease reported by Gourin and Johnson was 48%.[8]

Financial support and sponsorship

Sri Devaraj Urs Medical College.

Conflicts of interest

There are no conflicts of interest.

  References Top

Gorsky M, Epstein JB, Oakley C, Le ND, Hay J, Stevenson-Moore P. Carcinoma of the tongue: A case series analysis of clinical presentation, risk factors, staging, and outcome. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2004;98:546-52.  Back to cited text no. 1
Carlson ER, Ord RA. Vertebral metastases from oral squamous cell carcinoma. J Oral Maxillofac Surg 2002;60:858-62.  Back to cited text no. 2
Lee KH, Halfpenny W, Thiruchelvam JK. Spinal cord compression in patients with oral squamous cell carcinoma. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 2007;103:e16-8.  Back to cited text no. 3
Feng H, Wang J, Guo P, Xu J, Feng J. C3 vertebral metastases from tongue adenoid cystic carcinoma: A rare case report. Medicine (Baltimore) 2015;94:e1135.  Back to cited text no. 4
Törnwall J, Snäll J, Mesimäki K. A rare case of spinal cord metastases from oral SCC. Br J Oral Maxillofac Surg 2008;46:594-5.  Back to cited text no. 5
Mones RJ, Dozier D, Berrett A. Analysis of medical treatment of malignant extradural spinal cord tumors. Cancer 1966;19:1842-53.  Back to cited text no. 6
Harrington KD. Metastatic disease of the spine. J Bone Joint Surg Am 1986;68:1110-5.  Back to cited text no. 7
Gourin CG, Johnson JT. Surgical treatment of squamous cell carcinoma of the base of tongue. Head Neck 2001;23:653-60.  Back to cited text no. 8


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