28 years old male with a non healing ulcer on tongue since 3

28 years old male with a non healing ulcer on tongue since 3 months. Biopsy reveals a well differentiated squamous cell carcinoma. Further management welcomed



The various treatment options for the tongue carcinoma include Surgery, radiotherapy, chemotherapy and combined Modalities . Due to the mutilating affects of the surgical management of tongue carcinoma on the quality of life, organ preservation techniques and treatment protocols have to be used. The choice of the treatment depends upon tumor factors such as site, size (T stage), location and multiplicity, proximity to bone, pathological features, histology grade and depth of invasion. The patient factors include status of cervical lymph nodes, previous treatments medical condition of the patient. The various flaps for mobile tongue include local (mucosal, Buccinator flaps), local neck flap(infrahyoid),free flaps (forearm free flap, antero-lateral thigh flap).

Totally agreed with you Sir. To know bony invasion CT scan and for muscles invasion of tongue MRI should be done. Neck CT will tell levels of nodes involved and to decide type of neck dissection which is a must for tongue CA. Patient of young age usually have aggressive Tm and hence needs aggressive management at the earliest Dr. Panigrahi has nicely described different reconstruction methods. So Surgery hemiglossectomy may be segmental or Hemingway manfibulecyomy with neck dissection and recons. To be followed by RT. If M1 prognosis bad

Staging then decide if localised surgery or RT if advanced surgery and RT

Yes he requires rdical glossectomy/ or Hemiglssectomy along with Radiation & Chemothrapy.

Thanks , Sir

Do a CECT BOS to T4 to evaluate the disease extent and proceed accordingly.

CT OF neck and oral cavity . Reconstruction planning. Extent of carcinoma to tongue base will require more radical approaches.

hemiglosectomy n radioth

Yes he shell require radical glosectomy

What is the extend of the lesion on oral examination? Is there cervical lymphadenopathy? What is the status of floor of mouth and base of tongue? Plan:CECT (skull base to root of neck) Biopsy(has been done) Staging, oncophysician reference After that: surgery or radiotherapy.


Ref to oncologist

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