CASE REPORT   

European Journal of Oral and Maxillofacial Surgery 2020 August;4(2):52-6

DOI: 10.23736/S2532-3466.19.00188-7

Copyright © 2019 EDIZIONI MINERVA MEDICA

language: English

Multiple distant metastases from carcinoma of the tongue, including lymphangitis carcinomatosis

Nadeena S. JAYASURIYA ¹ ✉, Kumara EKANAYAKE ², Mapa R. BANDARA ³

¹ Department of Oral and Maxillofacial Surgery, Faculty of Dental Sciences, University of Peradeniya, Kandy, Sri Lanka; ² Department of Oral and Maxillofacial Surgery, Ulster Hospital Dundonald, Belfast, UK; ³ Department of Radiology, National Hospital, Colombo, Sri Lanka

Oral cancer of the tongue has high morbidity and mortality due to loco-regional spread of disease rather than with distant metastasis beyond the clavicle. Literature has only a few reported cases of multiple symptomatic distant metastases including pulmonary lymphangitis carcinomatosis in patients with carcinoma of the oral tongue. We describe two cases of primary squamous cell carcinoma of the oral tongue, where the patients developed multiple distant metastases. Radiographs suggested metastatic deposits of squamous cell carcinoma in the lungs of one patient, while pulmonary lymphangitis carcinomatosis in the other. Additionally, symptomatic distant metastases were seen in both patients; a pelvic bone lesion in the first and a scalp nodule in the second. Few months from surgical treatment to the primary site, both patients succumbed to disease due to sudden onset respiratory failure. Distant metastases including lymphangitis carcinomatosis should be suspected in symptomatic patients with oral tongue cancer. The management should be palliative from the time of diagnosis, as a rapid deterioration leading to death is inevitable.

KEY WORDS: Squamous cell carcinoma, Oral tongue, Distant metastasis, Lymphangitis carcinomatosis