Skip to main content

Advertisement

SpringerLink
Log in

Relationship between the appearance of tongue carcinoma on intraoral ultrasonography and neck metastasis

  • Original Article
  • Published:
Oral Radiology Aims and scope Submit manuscript

Abstract

Objective

To evaluate the usefulness of intraoral ultrasonography (IOUS) as a tool for predicting neck metastasis.

Introduction

Squamous cell carcinoma (SCC) of the tongue is aggressive and has a great propensity to metastasize to cervical lymph nodes. SCC of the oral cavity has a worse prognosis when associated with metastatic cervical nodes. Therefore, the metastatic potential of tongue carcinoma should be graded preoperatively to help determine the requirement for neck dissection.

Methods

Nineteen patients (11 men, 8 women) between 36 and 79 years of age (mean age 60) with T1 to T4a TNM-stage tongue carcinomas were evaluated preoperatively with IOUS. Clinical and pathological TNM classifications were performed.

Results

The average tumor thicknesses measured using histological sections were significantly (p < 0.01) lower than those with IOUS (1.3 vs. 1.6 cm, respectively). A significant correlation was observed between the tumor thickness measured using ultrasonography and that measured using histological sections (pathology). Based on this greater accuracy, the cutoff point of tumor thickness based on IOUS evaluation for predicting neck metastasis was determined to be 1.8 cm.

Discussion

Some factors may influence neck metastasis. A knowledge of these would help to avoid unnecessary surgical intervention for N0 patients. The results of this study indicates that there is a significant correlation between neck metastasis and tumor thickness.

Conclusion

Intraoral ultrasonography is useful tool for identifying tongue tumors and measuring their thickness, with the thickness measured by IOUS showing a very good correlation with histological measurements. Moreover, IOUS provides prognostic information prior to surgical treatment since tumor thickness can predict the chance of recognizing metastatic cervical nodes.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Brasil-Ministério da Saúde-Secretaria de Atenção à Saúde-Coordenação de Prevenção e Vigilância. Estimativa 2005: Incidência de Câncer no Brasil. Rio de Janeiro: INCa; 2004.

  2. Shintani S, Yoshihama Y, Ueyama Y, Terakado N, Kamei S, Fijimoto Y, et al. The usefulness of intraoral ultrasonography in the evaluation of oral cancer. Int J Oral Maxillofac Surg. 2001;30:139–43.

    Article  PubMed  Google Scholar 

  3. Durazzo MD, de Araujo CE, Brandao Neto JS, Potenza AS, Costa P, Takeda F, et al. Clinical and epidemiological features of oral cancer in a medical school teaching hospital from 1994 to 2002: increasing incidence in women, predominance of advanced local disease, and low incidence of neck metastases. Clinics. 2005;60:293–8.

    Article  PubMed  Google Scholar 

  4. Snow GB, Annyas AA, van Slooten EA, Bartelink H, Hart AA. Prognostic factors of neck node metastasis. Clin Otolaryngol Allied Sci. 1982;7:185–92.

    Article  PubMed  Google Scholar 

  5. Natori T, Koga M, Anegawa E, Nakashima Y, Tetsuka M, Yoh J, et al. Usefulness of intra-oral ultrasonography to predict neck metastasis in patients with tongue carcinoma. Oral Dis. 2008;14:591–9.

    Article  PubMed  Google Scholar 

  6. Stuckensen T, Kovacs AF, Adams S, Baum RP. Staging of the neck in patients with oral cavity squamous cell carcinomas: a prospective comparison of PET, ultrasound, CT and MRI. J Craniomaxillofac Surg. 2000;28:319–24.

    PubMed  Google Scholar 

  7. Spiro RH, Huvos AG, Wong GY, Spiro JD, Gnecco CA, Strong EW. Predictive value of tumor thickness in squamous carcinoma confined to the tongue and floor of the mouth. Am J Surg. 1986;152:345–50.

    Article  PubMed  Google Scholar 

  8. Massano J, Regateiro FS, Januario G, Ferreira A. Oral squamous cell carcinoma: review of prognostic and predictive factors. Oral Surg Oral Med Oral Pathol Oral Radiol Endod. 2006;102:67–76.

    Article  PubMed  Google Scholar 

  9. Keum KC, Chung EJ, Koom WS, Cho JH, Cho SH, Choi EC, et al. Predictive value of p53 and PCNA expression for occult neck metastases in patients with clinically node-negative oral tongue cancer. Otolaryngol Head Neck Surg. 2006;135:858–64.

    Article  PubMed  Google Scholar 

  10. Shintani S, Nakayama B, Matsuura H, Hasegawa Y. Intraoral ultrasonography is useful to evaluate tumor thickness in tongue carcinoma. Am J Surg. 1997;173:345–7.

    Article  PubMed  Google Scholar 

  11. Gonzalez-Moles MA, Esteban F, Rodriguez-Archilla A, Ruiz-Avila I, Gonzalez-Moles S. Importance of tumour thickness measurement in prognosis of tongue cancer. Oral Oncol. 2002;38:394–7.

    Article  PubMed  Google Scholar 

  12. Kurokawa H, Yamashita Y, Takeda S, Zhang M, Fukuyama H, Takahashi T. Risk factors for late cervical lymph node metastases in patients with stage I or II carcinoma of the tongue. Head Neck. 2002;24:731–6.

    Article  PubMed  Google Scholar 

  13. Yuen AP, Lam KY, Wei WI, Lam KY, Ho CM, Chow TL, et al. A comparison of the prognostic significance of tumor diameter, length, width, thickness, area, volume, and clinicopathological features of oral tongue carcinoma. Am J Surg. 2000;180:139–43.

    Article  PubMed  Google Scholar 

  14. Prince S, Bailey BM. Squamous carcinoma of the tongue: review. Br J Oral Maxillofac Surg. 1999;37:164–74.

    Article  PubMed  Google Scholar 

  15. Fukano H, Matsuura H, Hasegawa Y, Nakamura S. Depth of invasion as a predictive factor for cervical lymph node metastasis in tongue carcinoma. Head Neck. 1997;19:205–10.

    Article  PubMed  Google Scholar 

  16. Woolgar JA. Micrometastasis in oral/oropharyngeal squamous cell carcinoma: incidence, histopathological features and clinical implications. Br J Oral Maxillofac Surg. 1999;37:181–6.

    Article  PubMed  Google Scholar 

  17. Woolgar JA. Histological distribution of cervical lymph node metastases from intraoral/oropharyngeal squamous cell carcinomas. Br J Oral Maxillofac Surg. 1999;37:175–80.

    Article  PubMed  Google Scholar 

  18. Holm LE, Lundquist PG, Silfversward C, Sobin A. Histological grading of malignancy in squamous cell carcinoma of the oral tongue. Acta Otolaryngol. 1982;94:185–92.

    Article  PubMed  Google Scholar 

  19. Yamamoto E, Miyakawa A, Kohama G. Mode of invasion and lymph node metastasis in squamous cell carcinoma of the oral cavity. Head Neck Surg. 1984;6:938–47.

    Article  PubMed  Google Scholar 

  20. Byers RM, El-Naggar AK, Lee YY, Rao B, Fornage B, Terry NH, et al. Can we detect or predict the presence of occult nodal metastases in patients with squamous carcinoma of the oral tongue? Head Neck. 1998;20:138–44.

    Article  PubMed  Google Scholar 

  21. Ho CM, Lam KH, Wei WI, Lau SK, Lam LK. Occult lymph node metastasis in small oral tongue cancers. Head Neck. 1992;14:359–63.

    Article  PubMed  Google Scholar 

  22. Pimenta Amaral TM, Da Silva Freire AR, Carvalho AL, Pinto CA, Kowalski LP. Predictive factors of occult metastasis and prognosis of clinical stages I and II squamous cell carcinoma of the tongue and floor of the mouth. Oral Oncol. 2004;40:780–6.

    Article  PubMed  Google Scholar 

  23. Asakage T, Yokose T, Mukai K, Tsugane S, Tsubono Y, Asai M, et al. Tumor thickness predicts cervical metastasis in patients with stage I/II carcinoma of the tongue. Cancer. 1998;82:1443–8.

    Article  PubMed  Google Scholar 

  24. Kane SV, Gupta M, Kakade AC, D’Cruz A. Depth of invasion is the most significant histological predictor of subclinical cervical lymph node metastasis in early squamous carcinomas of the oral cavity. Eur J Surg Oncol. 2006;32:795–803.

    Article  PubMed  Google Scholar 

  25. Mohit-Tabatabai MA, Sobel HJ, Rush BF, Mashberg A. Relation of thickness of floor of mouth stage I and II cancers to regional metastasis. Am J Surg. 1986;152:351–3.

    Article  PubMed  Google Scholar 

  26. Moore C, Flynn MB, Greenberg RA. Evaluation of size in prognosis of oral cancer. Cancer. 1986;58:158–62.

    Article  PubMed  Google Scholar 

  27. Myers JN, Elkins T, Roberts D, Byers RM. Squamous cell carcinoma of the tongue in young adults: increasing incidence and factors that predict treatment outcomes. Otolaryngol Head Neck Surg. 2000;122:44–51.

    Article  PubMed  Google Scholar 

  28. O’Brien CJ, Soong SJ, Urist MM, Maddox WA. Is modified radical neck dissection only a staging procedure? Cancer. 1987;59:994–9.

    Article  PubMed  Google Scholar 

  29. Urist MM, O’Brien CJ, Soong SJ, Visscher DW, Maddox WA. Squamous cell carcinoma of the buccal mucosa: analysis of prognostic factors. Am J Surg. 1987;154:411–4.

    Article  PubMed  Google Scholar 

  30. Yuen AP, Ng RW, Lam PK, Ho A. Preoperative measurement of tumor thickness of oral tongue carcinoma with intraoral ultrasonography. Head Neck. 2008;30:230–4.

    Article  PubMed  Google Scholar 

Download references

Acknowledgments

No external funding was received for this study.

Conflict of interest

None declared.

Author information

Authors and Affiliations

  1. Department of Radiology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255-3o.andar-Cerqueira Cesar, São Paulo, SP, 05403-001, Brazil

    Maria C. Chammas, Túlio A. A. Macedo & Giovanni G. Cerri

  2. Head and Neck Surgery Department, Faculty of Medicine, University of São Paulo, Av. Dr. Enéas de Carvalho Aguiar, 255-3o.andar-Cerqueira Cesar, São Paulo, SP, 05403-001, Brazil

    Raquel A. Moyses, Marcelo D. Durazzo & Cláudio R. Cernea

  3. Pathology Department, Faculty of Medicine, University of São Paulo, Av. Dr. Arnaldo, 455-Cerqueira César, 01246903, São Paulo, SP, Brazil

    René Gerhard

Authors
  1. Maria C. Chammas
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Túlio A. A. Macedo
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Raquel A. Moyses
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. René Gerhard
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Marcelo D. Durazzo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Cláudio R. Cernea
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Giovanni G. Cerri
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Túlio A. A. Macedo.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Chammas, M.C., Macedo, T.A.A., Moyses, R.A. et al. Relationship between the appearance of tongue carcinoma on intraoral ultrasonography and neck metastasis. Oral Radiol 27, 1–7 (2011). https://doi.org/10.1007/s11282-010-0051-8

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11282-010-0051-8

Keywords

Search

Navigation