Late (>5 years) regional lymph node metastasis of oral squamous cell carcinoma (SCC), proven by p53 mutation analysis

SummaryBackgroundA late (>5 years) neck nodal metastasis of oral cancer, poses a problem to the clinician: is it a late metastasis or a metastasis of a (unknown) second primary tumour?MethodsA 50-year-old male was seen with a contralateral lymph node metastasis, 5½ years after treatment of a pT2N1M0 carcinoma in the floor of the mouth. Both the late metastasis and the original tumour specimen were analysed for p53 mutations.ResultsBoth specimens showed an identical p53 mutation, thereby confirming the lymph node to be a late metastasis.ConclusionsA lymph node metastasis can occur more than 5 years after treatment of an oral squamous cell carcinoma. p53 mutation analysis is of help to discriminate it from a second primary tumour.