Cisplatin intra-arterial chemotherapy for recurrent maxillary gingival cancer and metastatic lymph nodes without radiation or surgery: A case report

• Published in: Radiology case reports 2025-01, Vol.20 (1), p.560-565
• Main Authors: Ohtani, Akemi, Saito, Masato, Hirokawa, Naoki, Okuda, Hiroki, Sato, Hiroki, Nitta, Kenichiro, Mafune, Shoh, Miyazaki, Akihiro, Dehari, Hironari, Someya, Masanori
• Format: Article
• Language: English
• Subjects: Case Report; Head and neck cancer; Intra-arterial chemotherapy; Lymph node metastasis; Recurrence; Seldinger's method
• ISSN: 1930-0433; 1930-0433
• DOI: 10.1016/j.radcr.2024.10.081

Most patients with head and neck cancers struggle with their treatment, particularly those with recurrent cancer. However, there is no consensus on effective treatments for recurrent head and neck cancer. Recurrent cases are often challenging to treat because performing both reirradiation and surgical intervention can occasionally be difficult. This report describes the effective cisplatin intra-arterial chemotherapy with oral S-1 for a recurrent case of maxillary gingival cancer (rT4bN1M0, rStage ⅣB). The patient who had undergone chemoradiotherapy 13 years ago and achieved complete response (CR) was referred to us due to recurrence. His recurrent lesions were located on the left maxillary bone, and a metastatic cervical lymph node was detected. We approached the feeder of the locoregional recurrence site using Seldinger's technique and repeated the cisplatin intra-arterial chemotherapy 5 times. As a result, we achieved a complete response, including the regional metastatic lymph node, without radiation or surgery. Notably, although we infused the anticancer drug into the feeder of the locoregional metastatic area, we noticed its effect on the metastatic cervical lymph node. Initially, neck dissection following intra-arterial chemotherapy had been planned; however, owing to the high effectiveness of the treatment, the subsequent surgery was deemed unnecessary. No evidence of recurrence has been observed during the 2.5-year follow-up period. In the future, intra-arterial chemotherapy can be an alternative option for patients with recurrent head and neck cancers, and our result seems to be enough to indicate that possibility.