Tongue Cancer, at least T2N2
Findings:
A poorly defined soft tissue mass is located deep to the right SCM, along the right carotid sheath/jugulodigastric nodal chain, causing extrinsic compression of the right IJ vein. A superimposed deeply ulcerated soft tissue mass involves the right base of tongue, likely involving intrinsic and possible extrinsic tongue musulature.
Discussion:
nStaging of oropharyngeal SCCa
n<2cm T1, 2-4 cm T2, >4cm T3, extrinsic tongue/other invasion T4
n15-29 mm N1, 3-6 cm N2a, mult ipsil <6 cm N2b, >6cm N3a, mult bilateral N3b, contralateral only N3c, (N3d) extracapsular
nExtracapsular spread
nIrregular margins, carotid encasement, SCM
nDecreases survival by 50% and is best indicator of local treatment failure
nCriteria
n>= 15 mm max diameter deep cervical, spinal accessory, submental/submandibular
n>= 10 mm parotid or retropharyngeal
nCentral necrosis of any size
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