A 38-year-old woman presents with a carcinoma of the lateral aspect of the lower lip. To which lymph node group does this most directly drain, and what is the clinical significance?

• A Bilateral submental nodes due to midline crossing, then to bilateral deep cervical chain
• B Ipsilateral submental and submandibular nodes, then to deep cervical chain; risk of ipsilateral nodal metastasis ✓
• C Directly to internal jugular chain (jugulodigastric node) without submental relay
• D Parotid nodes directly, then to upper deep cervical nodes

Explanation

The lateral lower lip drains primarily to the ipsilateral submandibular lymph nodes, then to the ipsilateral deep cervical (internal jugular) chain. The central lower lip and chin drain to bilateral submental nodes and can cross midlines. Carcinoma of the lateral lip therefore carries a risk mainly of ipsilateral nodal metastasis, whereas central lower lip lesions risk bilateral nodal spread. This distinction is clinically relevant for neck dissection planning.

Reference: BD Chaurasia's Human Anatomy, 8th ed.

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Written and medically reviewed by the StethoPrep medical team.