Microinvasive SCC of the tongue - now what? - 05-21-2013 08:29 PM
hello everyone,
I'm really happy to have found this site, and for all the wonderful folks that take the time to post. No one wants this, but having others to help with the journey is comforting.
My brother had a right lateral tongue biopsied in early April. The initial pathology report showed 'mild dysplasia'. Being an experienced patient myself, I asked for a second opinion on the pathology. The second report graded the biopsy as "high grade dysplasia".
I immediately took my brother to a CCC near us (University of Chicago), and had the lesion taken out via a wide local excision. The final pathology report showed, "Ulcerated mucosa with moderate-severe dysplasia, and a focus of microinvasive squamous cell carcinoma"; the margins were negative.
I know he is relatively fortunate; it could have been worse. But, I know this disease is notorious for its varied behavior.
My question is - now what? We have a follow-up meeting with the ENT oncologist next week. But, what is the typical protocol after this? I'm wondering:
1. Will (or should) he undergo neck dissection?
2. Will (or should) he get MRI/CT/PET-CT (or all 3)?
3. His biopsy wasn't tested for HPV. Should it be?
Sorry for the flurry of questions. I'm still digesting this. A small part of me was hoping that the final pathology would show just mild dysplasia. Now I have to accept the reality of the situation. I'm planning on getting a second opinion at MSKC or MD Anderson, regardless of what our ENT tells us next week.
Tom
I'm really happy to have found this site, and for all the wonderful folks that take the time to post. No one wants this, but having others to help with the journey is comforting.
My brother had a right lateral tongue biopsied in early April. The initial pathology report showed 'mild dysplasia'. Being an experienced patient myself, I asked for a second opinion on the pathology. The second report graded the biopsy as "high grade dysplasia".
I immediately took my brother to a CCC near us (University of Chicago), and had the lesion taken out via a wide local excision. The final pathology report showed, "Ulcerated mucosa with moderate-severe dysplasia, and a focus of microinvasive squamous cell carcinoma"; the margins were negative.
I know he is relatively fortunate; it could have been worse. But, I know this disease is notorious for its varied behavior.
My question is - now what? We have a follow-up meeting with the ENT oncologist next week. But, what is the typical protocol after this? I'm wondering:
1. Will (or should) he undergo neck dissection?
2. Will (or should) he get MRI/CT/PET-CT (or all 3)?
3. His biopsy wasn't tested for HPV. Should it be?
Sorry for the flurry of questions. I'm still digesting this. A small part of me was hoping that the final pathology would show just mild dysplasia. Now I have to accept the reality of the situation. I'm planning on getting a second opinion at MSKC or MD Anderson, regardless of what our ENT tells us next week.
Tom