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Retromolar Trigone Squamous Cell Carcinoma

  •  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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