Permalink : http://hdl.handle.net/2115/57099

KEYWORDS : buccal mucosal carcinoma;facial lymph node;mandibular lymph node;metastasis;squamous cell carcinoma;頬粘膜癌;顔面リンパ節;下顎リンパ節;転移;扁平上皮癌

口腔癌の顔面リンパ節への転移，とりわけ下顎リンパ節への転移はまれである．今回われわれは下顎リンパ節への転移を認めた頬粘膜癌の一例を報告する．症例は，70才男性で，右頬粘膜扁平上皮癌（T1M0N0）の患者で，腫瘍切除術を施行し，術後３か月に顎下リンパ節転移を認めたため，肩甲舌骨筋上頚部郭清術を施行した．さらに２か月後，右下顎体部の外側に20 × 20 mm大の腫瘤を認め，CT，MRIより下顎リンパ節転移と診断した．リンパ節摘出術と術後照射を施行したが，術後８か月後に下顎リンパ節再発により永眠された．
Metastasis of oral cancer to the facial lymph nodes, especially to the mandibular lymph nodes is rare. We report a case of buccal mucosal carcinoma with mandibular lymph node metastasis. A 70 year-old-man with right buccal squamous cell carcinoma （T1M0N0） underwent surgical excision. Three months after the surgery, metastasis to the submandibular node was detected. The patient underwent supra-omohyoid neck dissection. But a further 2 months later, another 20 × 20 mm sized mass was observed superficially to the horizontal ramus of the mandible. The mass lesion was diagnosed with metastatic mandibular lymph node by CT and MRI. The lymph node was resected and postoperative irradiation was added. The patient died of the mandibular node recurrence 7 months after operation.