title: Neck dissections: emerging role of oral pathologists.
abstract: BACKGROUND
  Surgical resection has been the principle treatment approach for early lesions as well as advanced stage carcinomas of upper aero digestive tract. Neck dissection is the primary treatment given to nodal metastasis of oral carcinomas. Choice of irradiation and chemotherapy post surgery relies heavily on the histopathological assessment of surgical margins of resected tumor, dissected lymph nodes and accessory tissues.
  
  
  METHODS
  A total of ten cases of head and neck carcinomas reported in two years period were analyzed. The tissues were assessed histopathologically for tumor grade, margin status, nodal metastasis and vascular invasion.
  
  
  RESULTS
  Out of the total 10 neck dissection specimens, eight cases were of Well Differentiated Squamous Cell Carcinoma, one each of ameloblastic carcinoma and occult cancer with metastasis in cervical lymph nodes. In case of marginal clearance, two cases were negative, one case was of occult primary and seven cases had positive involvement at the margin, of which five cases demonstrated tumor component at <5mm from the surgical cut margin and two cases at >5mm. Concerning the nodal involvement, four cases were positive, five were negative, while in one case no lymph node was available for assessment. Among the accessory tissues received, submandibular gland and perinodal tissue involvement was seen in one case each whereas skin and muscle involvement was negative for tumor cells in all the cases.
  
  
  CONCLUSIONS
  The emphasis is on the role of oral pathologists in assessment of such neck dissection specimens. The information provided would maximize treatment outcome and minimize recurrence.
authors.affiliation: Mahatama Jyotiba Phule Rohailkhand University, Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Bareilly, 243006, Uttar Pradesh, India.
authors.forename: Madhusudan
authors.initials: M
authors.lastname: Astekar
authors.affiliation: Mahatama Jyotiba Phule Rohailkhand University, Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Bareilly, 243006, Uttar Pradesh, India.
authors.forename: Amolika
authors.initials: A
authors.lastname: Choube
authors.affiliation: Mahatama Jyotiba Phule Rohailkhand University, Department of Oral and Maxillofacial Pathology, Institute of Dental Sciences, Bareilly, 243006, Uttar Pradesh, India.
authors.forename: Gaurav
authors.initials: G
authors.lastname: Sapra
authors.affiliation: Keshlata Cancer Institute, Bareilly, 243001, Uttar Pradesh, India.
authors.forename: Rajesh Kumar
authors.initials: RK
authors.lastname: Chitlangiya
mesh_terms: D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000473:pathology; D002294:Carcinoma, Squamous Cell / Q000473:pathology; D006258:Head and Neck Neoplasms / Q000473:pathology; D006801:Humans; D008197:Lymph Node Excision / Q000379:methods; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis / Q000473:pathology; D008297:Male; D008875:Middle Aged; D009062:Mouth Neoplasms / Q000473:pathology*; D037981:Neck Dissection / Q000379:methods; D009367:Neoplasm Staging / Q000379:methods; D000072142:Pathologists
keywords: Diagnostic Histopathology; Head and Neck Cancer; Lymph Node Excision; Neck Dissection; Operative Surgical Procedures; Sentinel Lymph Node Biopsy