Greetings all - I had surgery on Dec 8th and am being released from the hospital tomorrow, Dec 19th. I was found to have a tumor on the base of my tongue (30%, right side) and had a partial glossectomy, neck dissection (with 34 lymph nodes removed, both sides), tracheostomy, and tissue taken from my right thigh to build my flap. All seems to be healing. The results of the pathology report highlight no tumor detected in lymph nodes, submandibular glands (both side) within normal limits, tongue resection invasive moderately to poorly differentiated squamous cell carcinoma.It then goes on to summarize tumor invades sub-epithelial tissue and intrinsic tongue muscle. Margins uninvolved by tumor. Present less than 0.1 cm from posterior and lateral-inferior margins. Lymphatic/vascular invasion; present, highlighted on VVG stain. Stage T4aN0

From what I can tell, the good news is that the margins were clear, and the lymph nodes showed no sign of the cancer invasion. I don’t understand the presence on the lymphatic/vascular invasion. Is this based on a different sample?

Overall it’s much better than what I went in thinking. From the PET scan, the dr estimated that it had crossed the midline and noted activity in my lymph nodes on the right side, and possibly the left. I understand the scans can be misleading (hard to keep my tongue still while having to do things like swallowing). But I’m unsure how to interpret the rest.

Apologies for all the questions, my doctor went out on leave and it was a resident that dropped the report off.

This sounds like the surgery was successful at dealing with the primary tumor. It is very common though for cells from that tumor to invade into the lymph drainage system, first in the cervical nodes of the neck. It doesn’t sound like in the process of your surgery they did any kind of neck dissection. That might mean that they are going to do that at a second surgery, or that they feel it is best addressed with radiation treatments or both. Please post back where they are with this so we might comment further. Dealing with any residual malignancy in the lymph system is important as that is a primary mechanism for it to spread to areas distant from the primary tumor.

Kymmi,

Welcome to the forum. Glad your surgery went well and your recovery is going well. As Brian said, would be good to understand any followup treatment they plan. I had a very similar diagnosis and surgery in April of 2020. They found cancer in one node but it was still inside the node. They recommended and I received radiation to my mouth and neck areas to kill all the remaining cancer. I received 30 radiation treatments totally 60 Gray Units to my mouth/tongue. They waited about 7-8 weeks after my surgery so I had time to gain back some weight and strength.

General note on surgery vs radiation. I found recovery from surgery to be faster than that from radiation. I felt noticeable improvement from surgery nearly every day. But, after radiation ended, I had to learn to judge my recovery in weeks and months. I still, 2+ years later, have some flavors that are whacky. I can eat most everything but nothing too spicy and alcohol tastes bad. And due to radiation treatment, I have many dental issues, cavities, crowns, root canals, receding gums, slow recovery to damage on gums, etc. Majorly worth it for the statistical recurrence improvements my oncologist quoted but still good to share.

Also, I suggest you insist a doctor answer all your questions. I used to keep a written list of questions for all my doctors visits (daily rounds in the hospital, follow ups, etc). I also kept that book next to me and learned to write down every question as they popped into my mind and I would have a good list for every face to face.

Stay safe and keep the faith.

Nels