43 yr old female presents with a tongue lesion on my on examination leve2 node palpable biopsy scc staging no extra findings expect what described suggestions for treatment




Wide excision and mnd thank you all for interaction

Kindly check for the induration clinically . It helps in determination of the clinical involvement of the tongue . Also b/l usg neck shd be done, as tongue presents with criss cross and skip metastatsis, alongwith mri tongue to see the involvement. Then treatment shd b planned accordingly.. most likely wide local excision of the lesion, glossectomy depending on the involvement with 1 cm margin clearance, selective neck dissection and reconstruction with suitable flap.

Staging already said so if you are planning sugary mnd is the answer

Partial glossectomy with2 cm margin left side with MRND left side with supraomohyoid lymph node dissection on right side.

Hemiglosectomy and MND

Depending on the MRI finding the resection of the tongue can be planned - WE , partial glossectomy or near total glossectomy and when addressing the neck FND can be carried out and if so introperatively any tumour spread is seen in one of the non lymphatic structures then one of them has to be sacrificed . Followed by reconstruction with a locoregional or a distant free flap.

Leukoplakia/Ca Oral cavity- Tongue & floor of mouth How is tongue movement & swallowing. H/O Tobacco usage. Inv- USG with FNAC neck. Biopsy from tongue lesion. CECT for extend and LNE status, if suspicious of malignancy.

Depending upon involvement either partial or hemi or total glossectomy and also radical neck dissection as u said level 2 lymph nodes are involved. Also usg of neck would be a good idea to define lymph nodes involved

Partial glossectomy mrnd dissection and reconstruction if 30 percent of tongue loss it can be local or distant preferably free tissue Alt or radial forearm but have to see other comorbidites before doing a free flap

Hemiglossectomy followed by MND followed by RT OR Concurrent chemoradiation depending on post surgical findings. .

After proper staging workup WLE glossectomy with left MRND with free radial forearm flap

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