Huh, I can't believe I did not add in this thread an update after my general anesthesia very partial glossectomy.

It's in the other thread I believe.

Anyway last February (2024) an ENT Onconology Surgeon did a very minor partial glossectomy around the biopsy site, under general anesthesia, to get sufficient margins around where the cancer was found and to also look for other cancer.

He did a throat scope as well.

Nothing of concern was found on the throat scope.

Pathology on the excised tongue showed no further cancer, but there was more dysplasia, and if I recall correctly, it again extended to the edges of the tissue, and I believe they termed it "low grade" dysplasia (and I think some folks use low grade to include minor and moderate dysplasia).

He did note some patchy white leukoplakia I believe in the retromolar trigone that I had asked about, but noted it was more consistent with Wickham striae, and was not currently concerning to him, although he'd keep careful attention to it on follow ups.

The first year post surgery it was follow ups every couple months after it healed.

This second year it is more every 3 months (sooner if something develops of course, they'd get me right in, and I send them pictures and ask questions as they arise via text messages on the patient portal, had a few odd cankers that erupted suddenly and then slowly healed, so far nothing has required an unscheduled urgent visit).

The one tiny spot, that I thought may have been (and may still be) a suture scar, still remains. A white tiny bump, way smaller than the pimple. Painless, and not changing. I need to remember to ask if that's normal for a suture scar like that to become permanent.

It doesn't bother me, it's just there.

A few more patchy leukoplakias, one below the scar(s).

The surgeon doesn't think it's necessary to biopsy those as of yet, until at least they become palpable to him. He is happy to do it, if I request it at any point.

He thinks in all liklihood, at worse it would likely just show more dysplasia, and we had that discussion about chasing dysplasia can be a loosing game, especially if it is scarring resulting from sutures and trauma to the tongue during surgery, and he agreed with the other oral surgeons.

We discuss it and he looks at all the abnormalities each visit.

I see him again in a week or two here shortly.

The area forward of the tongue still has that patch of tissue that "blanches" when my tongue is stretched out at time (capillary bleaching they believe, but oddly to me just that oval patch that does it, right adjacent to the scars, abutting right up to it). It also has a visibly smoother texture appearance, and feels kind of rubbery when you slide your finger acrross it. The rest of the tongue in that area, with saliva, the finger just glides over the tongue skin, even over the scars. That blanching oval region, my finger kind of grabs like a squeaky windshield wiper blade on a windshield. Kind of grabs and releases, grabs and releases, but the texture is smooth. Just odd observation. It is more sensitive to touch than all the other surrounding areas too. I can rub the scars vigorously and there is no discomfort. Rubbing this other vigorously isn't painful per se, just uncomfortable. Forward of that area there is a small short "ridge", that is about midline. That too is sensitive in a similar manner.

At times that ridge is more prominent. I do not believe it is merely from the fitting of the tongue to the space between your upper and lower teeth, but it does approximate that position, I think. I can't force my tongue to rub on my teeth in anyway that is the lest bit uncomfortable, teeth closed or opened.

One thing about documenting this, is if I did not, I could easily forget that this specific area IS NOT scar from any of the other procedures.

I'll need to remember to ask him about the area to the back of the scar, deeper. It looks to me as if there is some leukoplakia extending from the scar back as far as I can see in the mirror. I am pretty sure I could easily see the entire sutured area in the mirror and it stopped well short of the limits of what I could see.

It would be nice if medical science could develop Star Trek level PET/CT scans that could detect microscopic, or at least sub-millimeter tumors. I am willing to play guinea pig, if they want to test out any new techniques in imagery!

As I understand it sub-centimeter PET/CT is still a goal too far, and it seems as if my excised tumor, quite likely would not have shown on a scan? (I had an unrealistic expectation of what current PET/CT is likely to show)

So all these other minor lesions, it's this waiting game, and trying to figure out to let things ride, vs. keep biopsying.

So that's an update after the very minor partial glossectomy pathology results and where things are now.

I am another never smoker, only tried chewing tobacco like twice as a teenager 3 decades ago, very occasional (3-4 times a year) social drinker, 1-3 drinks typically.

I did used to use alcohol containing mouthwashes, quite a lot in my 20's and 30's. That's the only risk factor we've ID'd, in my more or less idiopathic generation of disease.

Have not used the alcohol containing mouth washes since, just tooth paste for me at the moment.

R/
CQ