Unanswered Questions on the Optimal Extent of Tongue Cancer Resections

Owing to the site- and stage-dependent molecular changes beyond the excised surgical margins of mucosal head and neck squamous cell cancers [HNSCC], an absolute cutoff for safe margins is difficult to define. Entrapment of the primary tumor in a specified compartment by a barrier clearance concept can circumvent this to a considerable extent, but it is not possible in all sites. A case of recurrent squamous cell cancer (SCC) of the tongue which had undergone wide excision of the lesion twice and later required a total laryngectomy because of crossover of the recurrent disease to the preepiglottic space and thereby to the glottis-supraglottic region is presented as an example to illustrate this predicament.