A case of tongue cancer suspected to be distant metastasis at the early stage in an elder patient

Tongue cancer patients with distant metastasis detected at the initial medical examination are rare. A case of tongue cancer in an elder patient suspected of metastasis to the hilus of the lung is reported. An 84-year-old man was referred to our department with a chief complaint of pain in the left part of the tongue on swallowing. Clinical diagnosis was malignant tumor in the left portion of the tongue (T3N0M1) . Chemotherapy and radiotherapy for primary tumor and lung metastasis were carried out. The size of the primary tumor was reduced by 65 %, and it was recognized that the treatments were also effective against the lung metastasis. However, fibrosis of lung developed. Thereafter, severe spontaneous pain in the tongue and necrosis of the tumor appeared. Therefore, partial resection of the tongue was performed under general anesthesia. Two months after surgery, the patient died of liver dysfunction.