oncology conference daniel todd, m.d. ent, p.c.. 43 yowm 3 month history of cervical lymphadenopathy...

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ONCOLOGY CONFERENCE DANIEL TODD, M.D. ENT, P.C.

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ONCOLOGY CONFERENCE

DANIEL TODD, M.D.

ENT, P.C.

43 YOWM

• 3 MONTH HISTORY OF CERVICAL LYMPHADENOPATHY

• NO TYPE B SYMPTOMS

• NO INFLAMMATORY SYMPTOMS

• SMOKER

43 YOWM

• SMOKER

• STILL OWNS HIS TONSILS

• OTHERWISE NL HEAD AND NECK EXAM

• RADIOLOGY

• PATH (FNA)

LYMPHOSCINTIGRAPHY

• 57 YOF• NATIVE

AMERICAN• SMOKER• ETOH HISTORY• 3 MONTH HISTORY

OF RIGHT LAT TONGUE LESION

LYMPHOSCINTIGRAPHY

• 2 CM ULCERATIVE / INDURATED R LAT ORAL TONGUE LESION

• OTHERWISE NL H & N EXAM

• NO PALPABLE ADENOPATHY

• RADIOLOGY:

LYMPHOSCINTIGRAPHY

• 58 YOWM

• SMOKER

• ETOH HISTORY

• 2 MONTH HISTORY OF RIGHT POSTERIOR/LATERAL TONGUE LESION

• OTALGIA

LYMPHOSCINTIGRAPHY

• 3 CM ULCERATIVE / INDURATED LESION EXTENDING POST TO THE CIRCUMVALLATE PAPILLAE

• OTHERWISE NL H& N EXAM• NO PALPABLE CERVICAL

LYMPHADENOPATHY

• RADIOLOGY:

LYMPHOSCINTIGRAPHY

• PRE-OP T2 N0 M0

• PRE-OP INJECTION AND GAMMA CAMERA SCAN

ADVANTAGES

• PRE-OP LOCALIZATION----DRAINAGE PATTERN RECOGNITION

• SLN IDENTIFIED FOR MORE ACCURATE PATH (SERIAL SECTIONS)

• CONFIRMATION OF REMOVAL OF ALL DRAINING NODES INTRAOPERATIVELY