Fig 4 - available from: World Journal of Surgical Oncology
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HE-stained images of the metastatic BN. The normal structure of lymph node is mainly replaced by necrotic tissue (original magnification × 20). HE, hematoxylin and eosin
Source publication
Background
Metastasis of oral cancer to the buccinator lymph nodes (BN) is uncommon. The antegrade lymphatic flow in patients with normal anatomy and physiology makes metastasis of lower gingival cancer to BN unlikely.
Case presentation
A 67-year-old woman presented with a 46 × 25-mm tumor on her lower gingiva, along with metastatic foci in BN and...
Context in source publication
Context 1
... cells and remnants of keratin pearls. The surgical margins were free from tumor. Metastatic dis- ease was detected in five cervical lymph nodes, including one left submandibular aggregated-node, three left upper jugular nodes, and one left middle jugular node. No metastatic nodes revealed extra-nodal extension. Metas- tasis to BN was also present (Fig. 4). These metastatic regions contained few viable cancer cells and consisted primarily of necrotic ...
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Oral cancers are the most common malignancy affecting Indian population with buccal mucosa being the frequent subsite. This study is to evaluate the histopathological factors influencing locoregional recurrence (LRR) and disease-free survival (DFS) in buccal mucosal squamous cell carcinoma (BSCC). One hundred and twenty patients treated surgically...
Citations
... As a result, lymphatic regurgitation may occur, and residual tumor cells may unexpectedly disseminate by a route that ignores the original lymphatic flow. [20][21][22] Yang et al hypothesized that extensive neck LN metastasis, particularly meeting the condition of N3, was a risk factor for lymphatic regurgitation to the occipital LN metastasis. 23 However, in the case we experienced, the pathological results of the LNs dissected in the initial surgery showed metastasis was found only in level IIa LN, but delayed metastasis to the occipital LN was found at 3 months postsurgery. ...
Consideration of unexpected metastasis in patients who have undergone neck dissection with advanced tumors must be anticipated with careful follow‐up. Consideration of unexpected metastasis in patients who have undergone neck dissection with advanced tumors must be anticipated with careful follow‐up.
Objective:
The use of the traditional American Joint Committee on Cancer (AJCC) staging system alone has limitations in predicting the survival of gingiva squamous cell carcinoma (GSCC) patients. We aimed to establish a comprehensive prognostic nomogram with a prognostic value similar to the AJCC system.
Methods:
Patients were identified from SEER database. Variables were selected by a backward stepwise selection method in a Cox regression model. A nomogram was used to predict cancer-specific survival rates for 3, 5 and 10 years in patients with GSCC. Several basic features of model validation were used to evaluate the performance of the survival model: consistency index (C-index), receiver operating characteristic (ROC) curve, calibration chart, net weight classification improvement (NRI), comprehensive discriminant improvement (IDI) and decision curve analysis (DCA).
Results:
Multivariate analyses revealed that age, race, marital status, insurance, AJCC stage, pathology grade and surgery were risk factors for survival. In particular, the C-index, the area under the ROC curve (AUC) and the calibration plots showed good performance of the nomogram. Compared to the AJCC system, NRI and IDI showed that the nomogram has improved performance. Finally, the nomogram's 3-year and 5-year and 10-year DCA curves yield net benefits higher than traditional AJCC, whether training set or a validation set.
Conclusion:
We developed and validated the first GSCC prognosis nomogram, which has a better prognostic value than the separate AJCC staging system. Overall, the nomogram of this study is a valuable tool for clinical practice to consult patients and understand their risk for the next 3, 5 and 10 years.
Oral squamous cell carcinoma is one of the most common epithelial malignant neoplasm affecting the oral cavity; early detection of this neoplasm plays an important role in achieving a good prognosis. Initially and occasionally, Oral squamous cell carcinoma of the gingiva may be misdiagnosed by its clinical appearance. Carcinomas of the gingiva constitute to approximately 10% of oral squamous cell carcinoma and can mimic oral lesions, especially those with benign features and are of inflammatory origin, often which leads to delay of diagnosis and treatment plan. This article reports a rare case of oral squamous cell carcinoma of gingiva in a 65-year-old male patient.
