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The fourth most common oral cavity and oropharynx malignancy (6% of cases), grouped with gingival SCCa due to similar history and management
Most telling diagnostic clue is the obliteration of buccal fat behind the parotid duct
Will spread via the pterygomandibular raphe which is loacted deep to the retromolar trigone
The pterygomandibular raphe is an important anatomical marker in cases of retromolar trigone SCCa
The pterygomandibular raphe attaches superiorly to the pterygoid hamulus, allowing tumor spread to base of skull or masticator space
The pterygomandibular raphe attaches inferiorly to the mylohyoid line of the mandible allowing for tumor spread to the floor of mouth
Most common nodal involvement includes levels I, II, and III
Ipsilateral nodal involvement seen in 39-56% of cases at presentation
Contralateral nodal involvement is seen in 8.8% of cases
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