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However, delayed metastases to lymph nodes outside the standard dissection range, such as the buccinator lymph nodes, may adversely affect the prognosis. We report the case of an 87\u2010year\u2010old woman with right maxillary gingival carcinoma with submandibular lymph\u2010node metastasis in whom en bloc resection of the maxilla and cervical region was performed with inclusion of the buccal space because of concern for possible occult lymphatic spread. Postoperative pathological examination revealed three metastatic submandibular lymph nodes and negative surgical margins. No recurrence was observed for &gt;\u20095 years after surgery. Buccinator lymph nodes are difficult to identify on preoperative imaging. Therefore, en bloc resection that includes the buccal space may be beneficial in high\u2010risk cases.<\/jats:p>","DOI":"10.1155\/crid\/6972361","type":"journal-article","created":{"date-parts":[[2026,7,20]],"date-time":"2026-07-20T04:28:29Z","timestamp":1784521709000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Maxillary and Cervical En Bloc Resection With Consideration of the Lymphatic Flow Pathway for Maxillary Gingival Carcinoma: A Case Report"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-7558-2944","authenticated-orcid":false,"given":"Y.","family":"Kondo","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"Kawahara","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"R.","family":"Nakamura","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Y.","family":"Tange","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7539-4257","authenticated-orcid":false,"given":"M.","family":"Ando","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,19]]},"reference":[{"key":"e_1_2_11_1_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiology.188.3.8351335"},{"key":"e_1_2_11_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.joms.2008.12.025"},{"key":"e_1_2_11_3_2","doi-asserted-by":"publisher","DOI":"10.1002\/hed.20005"},{"key":"e_1_2_11_4_2","first-page":"21","volume-title":"Vascularology","author":"Kamijo M.","year":"1986"},{"key":"e_1_2_11_5_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.bjoms.2004.10.003"},{"key":"e_1_2_11_6_2","doi-asserted-by":"publisher","DOI":"10.1053\/joms.2002.31253"},{"key":"e_1_2_11_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijom.2014.06.006"},{"key":"e_1_2_11_8_2","volume-title":"Anatomy of the Human Lymphatic System, English ed. 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