Buccinator and Mandibular Node Metastases in Oral Squamous Cell Carcinoma

Publication date: Available online 1 December 2018

Source: Journal of Oral and Maxillofacial Surgery

Author(s): Hirofumi Tomioka, Yumi Mochizuki, Toshimitsu Ohsako, Hideaki Hirai, Hiroaki Shimamoto, Hiroyuki Harada

Abstract

Purpose

The buccinator and mandibular nodes both belong to the facial lymph node group, and metastasis of oral cancer to these nodes is extremely rare. The purpose of this study was to indicate the particular rare metastasis cases wherein we administered treatment for the buccinator or mandibular nodes.

Patients and Methods

We identified 1479 cases of oral squamous cell carcinomas treated in our hospital from April 2001 to December 2016. After excluding cases with distant metastasis at initial treatment, perioperative mortality, and lack of follow-up data, the final study population consisted of 1406 cases.

Results

Six patients were identified who have pathological metastasis to either the buccinator or mandibular node. They consisted of 3 men and 3 women, and their ages ranged from 45 to 72 years, with an average of 59.3 years. The primary sites were the lower gingiva in 2 cases and the buccal mucosa in 4 cases. There were 2 cases of metastasis in the buccinator node, and 4 cases in the mandibular nodes. There were no cases of metastasis in both the buccinator and mandibular nodes. Each case also involved submandibular node metastasis. The outcome was 4 cases of disease-free survival and 2 deaths due to cancer; the cumulative disease-specific 5-year survival rate was 62.5%.

Conclusion

The possibility of metastasis to the buccinator and mandibular nodes should be considered in oral cancer wherein the primary tumor invasion reaches the buccinator muscle with submandibular node metastasis.

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