Previous Biopsy -- Right Cheek Mass

FINAL DIAGNOSIS:

PARTS 1 and 2: MUCOSA, RIGHT BUCCAL, EXCISIONAL BIOPSY -

A. INVASIVE WELL DIFFERENTIATED EXOPHYTIC SQUAMOUS CELL CARCINOMA (See comment).

B. STAGE T1 N1 Mx.

PART 3: LYMPH NODE, RIGHT NECK, HIGHEST LEVEL, EXCISIONAL BIOPSY -

NO TUMOR SEEN IN NINE (9) LYMPH NODES.

PART 4: TONGUE, RIGHT BASE, BIOPSY -

NO TUMOR SEEN.

PART 5: TONGUE, LEFT BASE, BIOPSY -

A. TRAUMATIC NEUROMA.

B. NO TUMOR SEEN.

PART 6: LYMPH NODES AND SUBMANDIBULAR GLAND, RIGHT NECK, ZONE I, EXCISIONAL BIOPSY -

A. INVASIVE WELL DIFFERENTIATED SQUAMOUS CELL CARCINOMA IN SOFT TISSUE AROUND SUBMANDIBULAR GLAND.

B. SEVEN (7) LYMPH NODES FREE OF TUMOR.

C. NO VASCULAR OR PERINEURAL INVASION SEEN.

PART 7: LYMPH NODES, RIGHT NECK, DISSECTION -

TWENTY THREE (23) LYMPH NODES FREE OF TUMOR

(TEN LYMPH NODES FROM SUPERIOR ASPECT OF SPECIMEN,

THIRTEEN LYMPH NODES FROM INFERIOR ASPECT OF SPECIMEN).

COMMENT:

There is some suggestion that this invasive squamous cell carcinoma is arising in a benign papillary keratosis. It is very difficult to evaluate the margins of resection due to cautery artifact. We do however see some dysplasia, but no overt carcinoma at the margin. The metastatic squamous cell carcinoma seen in the perisubmandibular soft tissue (Part 6), may represent a metastasis to an obliterated lymph node.

Gross Description