Metastasis to the submandibular gland in oral cavity squamous cell carcinomas: pathologic analysis

Abstract

CONCLUSION: This study demonstrates that the incidence of submandibular gland metastasis in oral cavity squamous cell carcinoma (SCC) is extremely rare and its involvement is through direct extension from a primary lesion. Therefore, if the primary lesion of the oral cavity carcinoma is not in close proximity and hence does not provide suspicion of direct extension, it may be safe to preserve the submandibular gland.

OBJECTIVES: Radiotherapy may lead to injury to the salivary glands resulting in xerostomia. This study aimed to determine whether and how the submandibular gland is involved in metastases of SCC of the oral cavity and to provide an oncological basis for preservation of the submandibular gland.

PATIENTS AND METHODS: This study reviewed the records and pathologic specimens of 201 patients who were diagnosed as having oral cavity SCC and underwent surgery at our institution, from 1991 to 2006, and pathologic metastasis to submandibular gland was evaluated.

RESULTS: In all, 44 cases (21.9%) were found to show ipsilateral level I metastasis on pathologic examination. Only two cases (1%) had carcinoma involvement in the submandibular gland. Both these two cases had direct extension from a primary lesion (retromolar trigone and floor of mouth) and no submandibular glands showed pathologic evidence of isolated metastasis or local extension of metastatic lymph nodes.