Unusual recurrence after chemoirradiation and surgery for squamous cell carcinoma of the tongue.

: Locally advanced squamous cell carcinoma of the tongue represents a significant therapeutic challenge. Novel methods using systemic chemotherapy with concurrent radiotherapy have been used to improve loco-regional response in patients who historically have poor prognosis. The simultaneous use of both modalities enhances planned local treatment by radiosensitization and potentially eradicates micrometastatic disease. With good local control, the appearance of distant metastasis or second primary tumors becomes a problem we need to address. Here, we describe a patient who completed concurrent chemoirradiation with good local response but only to relapse with unusual sites of metastases involving the scalp, gluteus muscle and right kidney. This represents a particularly aggressive form of disease with very poor prognosis.