Поражение лимфатических узлов шеи с контралатеральной стороны после лечения рака языка с отсутствием клинических признаков метастазов в лимфатических узлах шеи (клинический случай)

The objective is to present a clinical case of combined treatment of cancer of the tongue and its progression to the contralateral lymph nodes of the neck using data on individual lymphatic outflow from the primary tumor of the tongue. Clinical case. Clinical, laboratory, radiological and pathomorphological data of a 50-year-old patient with a diagnosis of squamous human papillomavirus-negative cancer of the free part of the tongue and clinically negative lymph nodes of the neck with cT2N0M0. The patient underwent radical surgical treatment in the amount of hemiglossectomy and ipsilateral selective cervical lymphadenectomy after two courses of polychemotherapy according to the cisplatin + 5-fluorocracil regimen with partial regression and adjuvant treatment in the amount of conformal remote radiation therapy combined with chemotherapy. 9 months after the end of treatment, progression to the lymph nodes of the neck of the contralateral side was revealed, which accumulated a radiopharmaceutical before treatment. Conclusion. The described clinical case shows the importance of studying the lymphatic outflow from the primary tumor of the tongue to the regional lymph nodes in order to plan surgical treatment on the regional lymphatic collector in patients with squamous cell carcinoma of the free part of the tongue.