Abstract
Our purpose was to provide a pathological basis for preservation of the submandibular
glands during neck dissection for oral squamous cell carcinoma (SCC) by investigating
whether intraglandular lymph nodes exist in submandibular glands, and the modes of
involvement of submandibular glands in oral SCC. We studied the records of 95 patients
with oral SCC (other than that in the floor of the mouth) treated at our hospital
from January 2017 to June 2018. The specimens of submandibular glands discarded after
neck dissection were analysed, and serially sectioned. Sections 5 μm thick were obtained at 0.5 mm intervals and stained with haematoxylin and eosin for examination under light microscopy.
A total of 116 specimens were obtained from the 95 patients, and about 5000 slides
were evaluated. No intraglandular lymph nodes were detected in the submandibular glands.
In the subgroup of patients whose primary tumours had extended into the floor of the
mouth, four submandibular glands were involved by direct spread of the primary tumour.
In the subgroup with metastases to level Ib lymph nodes, four submandibular glands
were involved by extranodal extension from the metastatic nodes. No intraglandular
lymph nodes or micrometastases were detected. We conclude that no intraglandular lymph
nodes are present in submandibular glands, which may be involved by direct extension
of the primary carcinoma or metastatic cervical lymph nodes with extranodal extension.
Preservation of the submandibular glands during neck dissection seems to be feasible
and safe in selected patients with oral SCC.
Keywords
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Article info
Publication history
Published online: December 18, 2019
Accepted:
November 20,
2019
Received:
March 12,
2019
Identification
Copyright
© 2019 The British Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.
