high grade, w/perineural invasion, extensive infiltration into skeletal muscle fibers and fibroconnective tissue and bone invasion, is the diagnosis for Carol's recurrence. (http://oralcancersupport.org/forums/ubbthreads.php?ubb=showflat&Number=118985#Post118985 and http://oralcancersupport.org/forums/ubbthreads.php?ubb=showflat&Number=120034#Post120034). I got the surgical pathology report during the 2 week post-op follow-up last Friday. After briefly reading the report and asking if Carol had clear margins since, the Dr. said everything was removed during surgery. But you could tell that he was concerned, became evasive and did not give a definitive answer. Carol has another follow-up in a week (9/3). Another CT Scan should be ordered then (4 weeks post-op). Operative word "will".

Researching this type of OC and what Carol was orginally DX'd with has me totally confused:

Original DX at left tonsillar pillar (T4N2bM0) but recurs near left mental foramen (chin, lip).

Path report 8/4/10 (day of surgery): Mucoepidermoid carcinoma:

1. 19 lymph nodes "suspicious" - 0 tumor
2. left neck anterior/superior/posterior margins superficial/deep - 0; BUT mandibular bone infiltrated by tumor, mandibular nerve infiltrated.
a. posterior mandible bone margin positive.
b. anterior mandibular bone margin-negative.
c. submandibular gland-negative.
3. Lymphovascular invasion: Indeterminate
4. Prior core biopsy (6/2010) says SCC but the pathology finding says its the same tumor, Mucoepidermoid carcinoma. (??)
5. Pathology Staging ypT4A N0 (post radiation).

Carol still has pain at her left ear, which is a symptom of OC, but is constant even after aggressive treatment and surgery. (No mention of the parotid gland in Carol's histology.)

There's no mention of other locations of tumors in the 1st 2 CT scans, but in the PET/CT scan done for pre-op there is bony erosion.

According to a piece at the American Cancer Foundation, the re-staging of cancer is rarely done and a recurrence and the staging of, is always as the orginal dx. How the hell could that be if the original dx is at the back of the mouth and recur at the front?

There are too many disparities with OC and when you THINK you understand something, someone comes along and blows it out of the water!

I have many questions but to my fogged brain at the moment, the need to visit the beach with cool soothing waves and a pina colada (in a VERY big coconut) would do wonders.

Linda

P.S. Is it possible for the signature line to have more characters? I would like to add the info regarding Carol's care and treatment without compromising with too many abbreviations, making it possible for current and future searches?