Carcinoma alveolus

60 years old male with moderately differentiated SCC right alveolus. Right SMG 3X2 cm LN enlarged, CT- mandible cortex eroded. Surgical plan?

(Edited)
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As per presentation, this case is cT4N2aMx.... Surgery is most desirable option. Modified Neck Dissection+ Segmental Mandibulectomy+ PMMC/Fibula free flap. Would have to send patient for PORT+-CT.
What about status of retromolar trigone/ nodal status... Segmental / Hemimandibulectomy + MRND/SOND and reconstruction with a fibular free flap or PMMC flap.
RMT free
0
composite resection /segmental resection of mandible +modified neck dissection+ vascularized fibula/pmmc flap
Try to plan for marginal mandibulactomy Try to plan for marginal mandibulactomy
Composite resection with mrnd with either free fibula recon or pmmc flap
Commando surgery needed for this

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