Long-term control of lung metastasis of tongue cancer treated effectively with cetuximab combination chemotherapy

Generally, systemic chemotherapy is indicated for oral squamous cell carcinoma with distant metastasis and has a poor prognosis. Recently, the advent of molecular targeted drugs, such as cetuximab and immune checkpoint inhibitors, has dramatically improved prognosis, though controlling distant metastasis remains challenging. We report a case of tongue cancer in which lung metastases disappeared in the long term. A 60-year-old Japanese male with squamous cell carcinoma of the tongue underwent preoperative chemoradiotherapy and surgery including subtotal glossectomy, bilateral modified radical neck dissection, and immediate reconstruction with an anterolateral thigh flap. One month after surgery, multiple nodules less than 10 mm in diameter appeared in both lungs on CT imaging. Multiple lung metastases were diagnosed with no local recurrence or regional lymph node metastasis. The patient continues to receive a 4-week treatment course of chemotherapy that included cetuximab every 3 months and the lung metastases were markedly reduced in size or had disappeared. No local recurrence or newly emerged metastases were observed. The patient has been doing well for nine years since the appearance of the lung metastases.