31 yr old female presented with Rt. Sided throat pain of 6 months duration.
She had an irregular lesion involving Rt. Tonsillar fossa, Rt.anterior & posterior pillars, uvula, with minimal extension towards Lt. Soft palate. Enlarged, hard, fixed Rt. level II lymph node detected.
CT Scan Neck : 4.2 x 1.9 x 2.4 cm. Rt. Tonsillar mass with anterior extension upto tonsillolingual sulcus, posteriorly parapharyngeal wall, superiorly upto palate and laterally limited by parapharyngeal fat. Level II A nodes – largest 12 x 13mm.
Surgery : Rt. Supraomohyoid neck dissection + CO2 Laser excision of Rt. Tonsillar malignancy – lateral resection upto carotid.
HPE : SCC infiltration positive at tonsillar bed (lateral extent), Level II nodes – extracapsular spread & Level III perinodal fibrous tissue.
Pt. planned for post-op RT
