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    Carcinoma Tongue Final Shailu

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    Shaku 2407

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    Carcinoma Tongue Final Shailu

    Uploaded by

    Shaku 2407
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    Download as pptx, pdf, or txt
    2 views20 pages

    Carcinoma Tongue Final Shailu

    Uploaded by

    Shaku 2407

    Copyright:

    © All Rights Reserved
    Download as PPTX, PDF, TXT or read online from Scribd
    Download as pptx, pdf, or txt
    You are on page 1of 20

    CARCINOMA TONGUE

    -Dr.R.SHAILESH
    KUMAR
    POST GRADUATE
    DEPARTMENT OF GENERAL SURGERY
    61 Year old male ,resident of Chennai ,presented with chief complaints
    of ulcer on the right side of tongue for 4 months
    History Of Presenting Illness
    • Patient was apparently normal before 4 months ,after which he noticed an ulcer over the right side of tongue
    • Which was insidious in onset ,noticed while eating spicy food,and gradually progressive in nature.
    • Associated with minimal pain at the site of swelling
    • Associated with excessive salivation
    • h/o sharp tooth +
    • No h/o restriction of mobility of tongue
    • No h/o restriction in opening of mouth
    • No h/o ear pain
    No h/o difficulty in chewing,swallowing,speech articulation
    • No h/o halitosis
    • No h/o swelling in the neck
    • No h/o of white patch or red patch in the mouth
    • No h/o of hemoptysis, dyspnea
    • No tobacco chewing, no smoking, no beetle nut chewing ,no alcohol
    PAST HISTORY
    • k/c/o type II diabetic mellitus for 2 yrs under regular medication
    • No h/o previous surgeries
    • No h/o any known allergey
    PERSONAL HISTORY
    • No addiction
    • His sleep and appetite normal
    • No H/o multiple sex partners.
    FAMILY HISTORY
    • No h/o any malignancy in any of the family members
    SUMMARY OF HISTORY

    • 61 yr old male,no addiction to abuse presented with 4 months history


    of non healing painless progressive ulcer in the right side of the
    tongue , associated with sharp tooth ,not associated with trauma.
    GENERAL EXAMINATION

    • Patient is conscious,cooperative, well built and nourished ,well oriented to


    time,place ,person
    • ECOG =1
    • Wt=75kgs ,height =168cm BMI=26.6 Kg/m2
    • No pallor ,icterus,cyanosis,clubbing,dehydration,lymphadenopathy
    and pedal edema
    • Pulse=78/min ,regular ,measured in right radial artery
    • BP=120/80 mmhg ,measured in right arm supine position
    • RR=18 breaths per minute ,regular
    • Temp=98.6 F
    Local Examination
    • INSPECTION
    • Facial symmetry normal
    • Mouth opening adequate
    • Ulcer noted in the right lateral border of tongue of size 2*2cm which is oval in
    shape ,irregular margin,raised edges mainly located on the lateral border of the
    tongue, anteriorly 3cm from the tip and posteriorly extending 3 cm from terminal
    sulcus,superiorly 3cm away from mid line of tongue, inferiorly 3cm from frenulum
    • Oral dental hygiene fair with no halitosis
    • Presence of sharp tooth
    • No visible bleed over the ulcer
    • Tongue movements are unrestricted
    • Rest of the oral cavity and neck appears normal
    PALPATION
    • Inspectory findings were confirmed
    • No tenderness present
    • Ulcer noted in the right lateral border of tongue of size 2*2cm which
    is oval in shape ,irregular margin,raised edges mainly located on the
    lateral border of the tongue, anteriorly 3cm from the tip and
    posteriorly extending 3 cm from terminal sulcus,superiorly 3cm away
    from mid line of tongue, inferiorly 3cm from frenulum
    • Induration present at base of ulcer
    • The ulcer doesn’t bleed on touch.
    • Rest of the buccal mucosa felt is normal
    NECK NODES

    • RIGHT SIDE OF NECK : NORMAL


    • LEFT SIDE OF THE NECK : NORMAL
    • NO PALPABLE LYMPHNODES
    SYSTEMIC EXAMINATION

    • CVS- S1 S2 heard, no murmur


    • RS-normal vesicular breath sound,no added sound
    • P/A-soft,non tender,no organomegaly
    • CNS- NFND
    PROVISIONAL DIAGNOSIS

    • Malignant ulcer of right lateral border of anterior tongue cT1N0M0


    INVESTIGATIONS

    • Edge biopsy
    • MRI head and neck
    • Chest xray
    BIOPSY REPORT
    • Moderately differentiated squamous cell carcinoma of tongue
    CONTRAST MRI OF HEAD AND NECK

    • 1.8x1.7cm enhancing lesion noted


    • On Right lateral border of tongue
    MRI TONGUE
    SURGICAL PLAN

    • Wide local excision of tongue with right selective neck dissection


    THANK YOU

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