Radical Mandibulectomy with Glossectomy for Floor of Mouth Cancer!!
Older male with history of dipping/chewing tobacco developed biopsy proven Squamous Cell Carcinoma of the floor of the mouth. This tumor not only involves the floor of mouth and base of tongue (white arrow), it actually invaded underneath and through the mandible, jutting out into the soft tissue anterior and inferior to the mandible. The light blue arrow on the bottom left shows the underlying tumor bulging up into the gums. The orange ink is done in Pathology to help asses surgical margins and make sure they're free of cancer. This surgical specimen was accompanied by bilateral neck dissections, containing the lymph nodes in the neck on both side. These are often sites of metastasis with head and neck cancer, and are removed to help stage the patient. Obviously, reconstruction must occur after a surgery like this, but I have no real knowledge on how thats done. I assume they try to use a piece of a bone from somewhere else in your body, but maybe a surgeon with some experience in this can chime in.
