instruction: hi doctor the imaging of the neck region was done and some lesions were detected the operation of lower jaw and neck region was done followed by chemotherapy and radiotherapy and it was stated that things will settle to normal during routine checkup some swelling in neck region was detected and fac was done which shows metastatic poorly differentiated squamous cell carcinoma and after that full body scan was performed the reports are attached kindly look into it as the second opinion is required
output: hello I am sorry to know the recurrence of cancer you got diagnosed with squamous cell carcinoma in buccal mucosa of the left oral cavity in december 2019 which was operated then you received chemotherapy and radiation therapy and now on routine evaluation there are some new lesions coming up in the thyearoid and neck so basically there are two sites of new lesions now in parotid and around it one more lymph node so please undergo a biopsy of this lesion from parotid to see if it is same cancer as before or a new second primary cancer if it is confirmed as same cancer as before it will be operated and taken out and also few more lymph nodes on the same side of the neck followed by chemotherapy if a second primary cancer then treatment can be different depending upon what type of cancer it is on biopsy so your first step is biopsy