Oral and maxillofacial surgery
Online only article
Spinal cord compression in patients with oral squamous cell carcinoma

https://doi.org/10.1016/j.tripleo.2006.11.041Get rights and content

Squamous cell carcinoma (SCC) is the most common malignancy arising in the oral cavity. It can cause severe morbidity and mortality due to its propensity to metastasis. Despite the likelihood of distant metastases, commonly to the lungs, there is little report in the literature of metastatic spread to the spinal vertebrae from oral SCC with secondary spinal cord compression. We report 2 patients with advanced SCC in the tongue who developed signs of spinal cord compression due to metastasis to lumbar vertebrae. The clinical impression of metastasis causing spinal cord compression was confirmed by magnetic resonance imaging.

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Case 1

A 52-year-old woman appeared with a 4-month history of an ulcer on the left lateral side of her tongue. The ulcer had increased in size over the last week, causing pain, dysphagia, and speech difficulties. Medically, she suffered from asthma and eczema. Her past surgical history included right hip replacement and lumpectomy for benign breast disease. Clinical examination revealed a 6-cm ulcer on the left lateral side of the tongue, which extended to the level of the epiglottis and the lateral

Discussion

In this report, both patients suffered severe morbidity and eventual death shortly after treatment for advanced oral SCC. Both patients had large-volume disease with nodal involvement on initial diagnosis. Both developed aggressive distant metastasis over a short period of time. Although they presented different clinical pictures, subsequent imaging confirmed metastatic spread to the spinal vertebrae.

Squamous cell carcinoma accounts for approximately 90% of all oral cancer, with the anterior

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