Hey there.... Ambra... cancer is unpredictable. They have a good idea normally where it will travel, but we are all individuals and we do not always follow the same path. SO it is possible to have a level IV node involved and no indication of others. What Paul said was correct, in that it could exist microscopically in other nodes and not be detected on a scan, or it could have been in the nodes and resolved itself (sometimes happens if your immune system gets ahead of it) or it could have jumped a bunch of nodes, or it could be a false alarm... I am not sure if it was biopsied or detected on a scan only but maybe its inflammation. Regardless, if you are going for rads it will be in the radiation path so it will likely be nuked. I can tell you I had a friend who had cheek cancer and they operated removed 20 nodes and patched her cheek (they removed the tumor and rebuilt it) and her 20 nodes tested negative for cancer so they thought she was good to go and did not recommend rads and chemo - a few months later another node popped up, and when she went back in they removed another 20 nodes and all had cancer. So it does happen. My question about all of it was - why didn't they remove more nodes to begin with, did they take the right nodes? (you have to assume your ENT knows his tuff - but that's not always the case) or did the pathologist not pick up the cancer in the first set of nodes? Or was she really an anomaly - and it genuinely skipped all those nodes. NO one knows for sure. This is why we always say - make sure you are being treated at a Cancer center that knows their stuff and deals with it every day. Also with regards to your dentist - there are dental oncologists out there. You should be looked at and treated by a dentist who handles patients with oral cancer. My hospital has that available in house. I even go to them now for cleanings and check ups.

hugs and best of luck.