Management Of Oral Squamous Cell Carcinoma With Clinically Negative Neck - A Case Report And Review Of Literature

The management of N0 neck is still controversial. Although the decision to observe or treat the N0 neck is left to the choice of the patient and the head and neck oncologist, in oral cavity carcinoma the only clinically N0 necks for which observation is appropriate are those associated with T1/T2 lip carcinomas, T1/T2 oral tongue carcinomas that are less than 4mm thick, T1/T2 floor of mouth cancers less than or equal to 1.5 mm thick. Lymph nodes in levels I-III are considered sentinel for oral cavity cancers. This well accepted concept forms the basis for prophylactic neck dissections where the likelihood of occult neck disease exceeds 20%. Selective Neck Dissection has been most utilized for elective treatment of regional lymphatics when the risk of metastasis is high. abuse for several years. There was no family history of malignancy. Medical history of the patient had no important episodes. The intraoral examination revealed an irregular, diffuse, reddish exophytic lesion over his left posterior buccal mucosa opposite molars and extending up to retromolar trigone, about 3 × 2 cm in size, oval in shape, non-tender on palpation and firm in consistency (Fig 1). Extra oral examination revealed no lymphadenopathy in submandibular or other neck triangles. Radiographic examination showed no bony invasion. Under the impression of malignancy, an incisional biopsy was performed under local anesthesia on the same day and the s p e c i m e n w a s s u b m i t t e d f o r histopathological examination, which demonstrated well differentiated squamous cell carcinoma. After obtaining the results of blood investigations with no abnormality and a fitness for surgery a written consent was