Buccinator and Mandibular Node Metastases in Oral Squamous Cell Carcinoma

The buccinator and mandibular nodes 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 examine particularly rare metastatic cases in which treatment was administered for the buccinator or mandibular nodes.

The authors identified 1,479 cases of oral squamous cell carcinoma treated at their 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 1,406 cases.

Six patients were identified who had pathologic metastasis to the buccinator or mandibular node (3 men and 3 women; age range, 45 to 72 yr; average age, 59.3 yr). The primary sites were the lower gingiva in 2 cases and the buccal mucosa in 4 cases. There were 2 cases of metastasis to the buccinator nodes and 4 cases of metastasis to the mandibular nodes. There were no cases of metastasis to the buccinator and mandibular nodes. Each case also involved submandibular node metastasis. The outcomes were disease-free survival in 4 cases and death from cancer in 2 cases; the cumulative disease-specific 5-year survival rate was 62.5%.

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