Hi all,
My dad aged 60 years and he has been found to have squamous cell
carisoma in floor of the mouth.
We have given him

1 chemo theraphy
33 sittings of cobalt 60 accumulating to 6600 units of radiation.

But after the radiation theraphy they said still residue exist. The
Doctors said that only option left is surgery but the chances of
reoccurance is high. So we decided to prolong rather than going for
surgery.

But 1 month after Radiation we decided to go for surgery the doctors
said surgery cant be done and its a advanced lesion with soft tissue
invasion.The patient could not bear the pain either....
Now we are going to another Oncologist who is giving chemotheraphy and
said we will reduce the tumor and do a surgery...But the tumor is only
getting larger... and larger.
So after 2 chemos the Doctor is suggesting radiation to reduce the
tumors.But it doesnt seem to reduce in radiation..

1) Is there any specific means to reduce the tumors in mouth??
2) Please find the MRI Report and let me know is surgery a option now?
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~
DUAL SLICE-CT-NECK

Helical plain and CECT study of the neck done followed by multiplanar
volume reconstruction:

Illdefined mildly enhancing soft tissue lesion seen in the floor of the
mouth towards the left side and in the left buccal space and
superficial to the body of the left hemimandible.

The margins between the lesion and tongue ( which appear to be indented
by the lesion ) along the posterior aspect is illdefined ( infiltration
appears more likely ) erosions of the body of left hemimandible along
the anterior aspect seen.

No evidence of significant regional lymphadenopathy.

The naso and laryngo pharynx regions appear normal with no definite
mass lesions identified.
Parapharyngeal fat planes appear preserved.

The carotid and jugular vessels appear normal.

IMPRESSION:
    Mildly enhancing neoplastic soft tissue lesion in the floor of the
mouth, left buccal space and superficial to the body of left
hemimandible with erosions involving mandible and possible
infiltrations of tongue posteriorly.
~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~RECENT
MRI NECK
--------

SEQUENCE:
---------

T1 WSE, T2 WFSE, STIR  - AXIAL
STIR              - CORONAL
T2 WFSE                - SAGITTAL

STUDY REVEALS:
--------------

Altered signal intensity of lesion appearing
hypointense on T1W images and hyperintense on T2W  and
T2FSE imasges images is noted in the left lateral
aspect of the floor of the mouth involving ipsilateral
mylohyoid muscle.There is suggestion of involvement of
the genioglossus muscle on the left.

Altered signal intensity with with stranding is noted
in the soft tissue plane of neck on the left side.

Subtle marrow changes appearing hypointense in T1 and
T2 and hyperintense in T2 fat suppressed sequences is
noted in mandible.CT screnning doesnot reveal any
cortical destruction.

INTERATEMPORAL FOSSA:
---------------------

Medical and lateral pterygoid plates appear normal on
both sides.
Pterygo palatine fossae appear normal on both sides,
Medical and lateral pterygoid muscles and deep head of
temporalis appear normal on both sides.

NOSOPHARYNX:
------------

Eustachian tube orifices and fossae of rossenumer
appear normal on both sides.
Longus appear normal on both sides.
No evidence of erosion of clivus.

OROPHARYNX:
-----------
OROPHARYNX APPEAR NORMAL.
-------------------------
LARYNX AND HYPOPHARYNX:
-----------------------

LARYNX AND HYPOPHARYNX appear normal .Epiglottis,
ary-epiglotttis folds valleculae and pyriform sinuses
appear normal, pre-eppilottis space appear normal.
False and true vocal cords appear normal.

PARAPHARYNGEAL SPACE:
---------------------
Prestyloid and post styloid compartments of
parapharyngeal space appear normal on both sides.
Tracheas appear normal in the neck.
Right and left lobes of thyroid gland appear normal.
Strap muscles appear normal.
Internal jugular vein and carotid artries appear
normal on both sides.
No evidence of significant cervical lymphadenopathy.
Parotid and submandibular glands appear normal on both
sides.
Trapezius muscles appear normal.

IMPRESSION:
-----------
Known cases of squamous cell carcinoma:-

1.IILDEFINED MASS LESION IN THE LEFT POSTERLATRATERAL
ASPECT OF FLOOR OF MOUTH WITH INVOLVEMENT OF
IPSILATERAL MYLOHYOID AND GENIOGLOSSUS MUSCLE.

2 NO SIGNIFICANT ENLARGED DEEP CERVICAL LYMPHNODES

3.POST RADIATION CHANGES IN THE NECK.

4 SUBTLE MARROW CHANGES IN MANDIBLE WITH NO CORTICAL
DESTRUCTION.

Suggested Contrast study for further evaluation.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~