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In case 4, the carcinomas in the submandibular gland and ipsilateral tonsil, the latter including an in situ component, were histologically similar keratinizing squamous tumors.
The surgeon makes a horizontal incision 2 cm from the patient's midline on the contralateral side and extends on the ipsilateral side of the neck to the anterior border of the sternocleidomastoid muscle.
As the child develops a preference for positioning, the ipsilateral sternocleidomastoid muscle shortens resulting in torticollis.
He or she then slides the guide wire up the iliac artery just past the renal arteries in the aorta on the ipsilateral (ie, primary) side.
In 4 of 11 patients whose lymph nodes were evaluated at this time, there was evidence of metastasis to the ipsilateral cervical lymph nodes.
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