Caregiver to my father; 66 yrs, diabetic normotensive with recurrent nodal metastasis

DX: Ulcerative lesion on left lateral border of tongue 2.5 months. [2009/02/01]
Biopsy: SCC LT LATERAL BORDER OF TONGUE. Well differentiated
CT: Ill-defined Assymetric enhancement in left oral tongue with 1.2x1.0x0.9 cm lymph node in left upper deep cervical region
TX: LT Partial Glossectomy + Left SOND. Stage 2 T2N1M0. [2009/02/16]
Histopath: Moderately differentiated SCC - left lateral border tongue infiltrating as cohesive broad sheets of strands. Depth of invasion 1.2 cm. Margins - all margins of resection free. Lymph nodes - 2/29 nodes show metastatic tumour deposit
TX: Concurrent CRT of 59.4Gy/33# + 6 cycles of weekly Cisplatin inj. [2009/03/18 to 2009/05/09]
Follow-up: Initially 15 days x 2, 1 month x 3 then quarterly.
DX: Ulcerative lesion on right tongue [2009/08/05]
PET-CT: No metabolically active/recurrent disease. Sub-cm metabolically active right upper cervical lymph-node could be inflammatory in nature. [2009/08/17]

Asymptomatic: [2009/08/17 � 2011/02/08], quarterly followup

DX: RT Neck Pain and clinically NED [2011/03/23]
CT: Heterogeneously enhancing nodal mass right neck level 2 � 3. Lesion: 4.2x2.7x6.5cm. RT Carotid vessels displaced medially, RT sternocleidomastoid muscle stretched laterally, IJV displaced and compressed. [2011/04/23]
PET-MRI: Enlarged metabolically active right upper mid-deep cervical nodal mass measuring 3.7(AP)x2.9(Tr)x5.8(CC) cm with perinodal infiltration of sternocleidomastoid muscle partially encasing right IJV with loss of flow and nodal thickening reaching about 2.5cm from jugular fossa [2011/04/29]
TX: 3 Cycles of Pallative chemotherapy with DCF regimen - Cisplatin (D1-D2: 60+60mg), Taxuba (D1: 120 mg), 5-FU (D1-D3: 1200mg). [2011/05/05 � 2011/05/07; 2011/05/26 � 2011/05/28; 2011/06/17 � 2011/06/19]
MRI: Enhancing nodal mass with cell necrosis � mildly progressive disease [2011/06/07]
TX: RND + Pectoralis Major Myocutaneous Flap; RT Sternocleidomastoid, IJV sacrificed, tumor peeled from RT Carotid; SAN preserved [2011/07/11]

Awaiting Biopsy reports.