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

Hello,

Welcome to icliniq.com.

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.

Hello,

Welcome back to icliniq.com.

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.