Management of the Clinically Node-Negative Neck in Oral Squamous Cell Carcinoma: A Case Report and Review of Prophylactic Treatment Considerations

Abstract

Squamous cell carcinoma (SCC) constitutes the majority of oral cavity neoplasms. For patients with clinically negative neck, the occurrence of occult metastases constitutes the primary rationale for elective treatment of the neck.

We present a case of a 47-year-old male smoker with a history of alcohol use who presented with a large growing tongue and tumor obstructing his airway. A biopsy confirmed SCC and the staging revealed a T3N0M0 tumor. The patient had no lymph nodes identifiable on clinical examination of the patient.

The patient underwent surgical resection of the tumor via partial glossectomy. During the procedure, a large exophytic cauliflower-appearing lesion, with a pedicled attachment to the left tongue was identified. Following surgery, the patient underwent radiotherapy for the management of the neck.

Prophylactic neck dissection is beneficial for patients with early-stage oral cancer and a clinically negative neck, offering a survival advantage and preventing advanced relapses.