Hello all,

My brother recently had a tongue lesion excised. The pathology report initially said "microinvasive" squamous cell carcinoma, with negative margins. When pressed what "microinvasive" meant, I was told 2mm of invasion. P16 testing was negative. Stage pT1NXMX.

A post-operative CT scan showed 2 "mildly enlarged" lymph nodes, which the surgeon felt were likely reactive.

Since the excision (4 months), my brother has been healing well, with no new sensitive areas.

The surgeon believes that the 2 nodes on CT are reactive. She feels that a PET-CT will likely result in an ambiguous answer (eg, reactive but cannot rule out metastasis), and thus force her to do a neck dissection, which she feels is not indicated.

I am driving myself and my brother crazy, trying to figure out what to do about those two nodes.

Does anyone have any personal experience, knowledge, or advice that can help me make this decision? What is the morbidity after a selective neck dissection (levels 1-4)?

Thank you
Tom