Presentation
Left sided sore throat and neck lump.
Patient Data
There is a left oropharyngeal moderately enhanced mass centered on the left tonsillar fossa. Anteriorly, the lesion infiltrates the anterior tonsillar pillar but does not extend to the tongue base. Posteriorly, the tumor invades the posterior tonsillar pillar reaching the posterior wall of the oropharynx. Laterally, the lesion infiltrates the left parapharyngeal space and abuts the medial pterygoid muscle, however, the sharp demarcation between the tumor and the muscle precludes deep invasion. Posterolaterally, the tumor abuts the internal carotid artery. The mass measures 4 x 4 x 3.7 cm in its maximum dimensions.
There are two left level II necrotic lymph nodes, the largest measures 2.5 x 2.5 x 1.5 cm in its maximum dimensions.
Case Discussion
Pathologically proven left tonsillar squamous cell carcinoma with left level II metastatic lymph nodes (T2 N2b).
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