Q. Even after surgery and chemo, some swelling in neck was detected as SCC. Is it possible?

Answered by
Dr. Pratik Patil
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on May 21, 2020

Hi doctor,

The imaging of the neck region was done and some lesions were detected. The operation of lower jaw and neck region was done followed by chemotherapy and radiotherapy and it was stated that things will settle to normal. During routine checkup, some swelling in neck region was detected and FNAC was done, which shows metastatic poorly differentiated squamous cell carcinoma, and after that full-body scan was performed. The reports are attached. Kindly look into it as the second opinion is required.



Welcome to

I am sorry to know the recurrence of cancer. (attachment removed to protect patient identity).

You got diagnosed with squamous cell carcinoma in buccal mucosa of the left oral cavity in December 2019 which was operated. Then you received chemotherapy and radiation therapy and now on routine evaluation, there are some new lesions coming up in the thyroid and neck.

So basically there are two sites of new lesions now, in parotid and around it one more lymph node. So please undergo a biopsy of this lesion from parotid to see if it is same cancer as before or a new second primary cancer.

If it is confirmed as same cancer as before, it will be operated and taken out and also few more lymph nodes on the same side of the neck followed by chemotherapy.

If a second primary cancer, then treatment can be different depending upon what type of cancer it is (on biopsy). So your first step is biopsy.

Thank you doctor,

The FNA is performed and the report is attached based on that FNA report the full body scan was performed. Now the doctor is saying for surgical removal of this lesion also stating that no other treatment is required. The following are my concerns for which your opinion is required.

Whether FNA will be adequate to diagnose this (report attached) or further biopsy will be needed as in your answer? The chemo and radiation have just finished (a month ago) is it advisable to go for operation again? As per the latest scans doctor told us that no other lesion is present in the body what is your opinion on that? If the surgery is performed what are the complexities in such kind of operation and what are the chances of success? Also, what are the chances of recurrence of this again as the first time we were told that the success rate is almost 100% but this happened?



Welcome back to

FNA (fine needle aspiration) report is adequate (attachment removed to protect patient identity) and should proceed for surgery. Chemo and radiation is finished I agree but the disease is back so it looks like an aggressive biology disease which needs to be treated aggressively.

It is a localized disease as on PET (positron emission tomography) scan so we are going for surgery followed by chemo (RT, if required, looking at post-surgery findings). We are going for curative resection.

Looking at the scans, surgery is feasible and not very complex, it will remove all nodes that are enlarged and all other normal nodes as well which will lessen the chances of further recurrence.

Note - This is aggressive disease biology, recurrence so soon after first chemo and radiation makes it a bad disease to have. Hence treatment needs to be aggressive and prompt.

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