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Base of tongue squamous cell carcinoma

Case contributed by Smita Deb
Diagnosis almost certain

Presentation

Palpable lymphadenopathy. 10 pack year history of cigarette smoking. Heavy alcohol consumption.

Patient Data

Age: 55
Gender: Male

A mass is centered in the left base of tongue filling the vallecula fossa. It has mild extension across the midline to the left side. There is thickening of the epiglottis, aryepiglottic folds and left lateral and posterior walls of the oro- and hypopharynx with mucosal thickening seen in the left posterior wall likely to represent submucosal tumor spread and edema.

Lymphadenopathy: Bilateral enlarged lymph nodes in levels 2 – 5 with a left sided conglomeration (5.6 x 4.6cm) seen in the sagittal plane. 

Case Discussion

Late stage oropharyngeal (left base of tongue) squamous cell carcinoma:

  • T4a: invasion of larynx (aryepiglottic folds)
  • N2c: metastasis in bilateral lymph nodes (not >6cm in greatest dimension)

Case contributed by Dr Smita Deb & A/Prof Pramit Phal.

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