Question

What is the appropriate management of a carcinoma of the lateral border of the tongue after primary resection?

• A. Chemotherapy
• B. Radiotherapy
• C. Observation
• D. Neck dissection

Hint:

Tongue cancers spread early to neck nodes, so the neck must be cleared surgically.

Answer 1

The Correct Option is D

Step 1: Understand the lymphatic risk. Carcinoma of the lateral border of the tongue has a high propensity for spreading to the cervical lymph nodes, even when nodes are not clinically obvious. So management cannot stop at resecting the primary tumor.

Step 2: Address the neck. When regional lymph nodes are involved, the neck must be treated surgically. This is done by a modified radical neck dissection or a selective neck dissection. Therefore neck dissection is the correct next step after resection.

Step 3: Why the other options are wrong. Observation risks leaving occult nodal disease untreated. Postoperative radiotherapy is added only for specific high-risk features such as perineural or angiolymphatic spread or positive nodes, not as the standalone next step. Chemotherapy alone is not the primary locoregional treatment here.