Carcinoma tongue T2N2bMx
Diagnosed in 1st march as scquamous cell carcinoma lateral border of tongue with no clinically pal palpable lymph node in posterior 1/3 rd in left side.operated on 9 the march 2016.hemiglossectomy with mendible swing and MRND.frozen was negative margin and paraffin comes clear margin and 2 lymph nodes positive out of56 and extranodal metastasis. Patient asked to come for radio therapy after 45 days.but on the 40th days after operation there is a swelling in the suture line.which gradually increase in size and day after that another lymph node found.every day there is a new lymph node.doctor advise for PET/CT and FNAC which detect a large recurrence in the retromolar trigon and in the neck area,in lung a very small calcification found which is not sure for metastasis.and in FNAC it found that lymph nodes are malignant.doctor advice for chemotherapy&after that if possible further excision and radiotherapy..but for last 3 days high WBC and chemo can't start.now what is the best treatment?
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