A patient has a malignant ulcer at the tip of the tongue near the midline. Which nodal group is the most likely first echelon of metastasis?

• A Submandibular nodes
• B Jugulodigastric nodes
• C Submental nodes ✓
• D Occipital nodes

Explanation

The tip of the tongue and the floor of the mouth near the midline drain primarily to the submental nodes, which sit between the two anterior bellies of digastric. From there lymph passes to submandibular and then deep cervical chains. The lateral tongue drains to ipsilateral deep cervical and jugulodigastric nodes, which is why that pattern does not apply here. Midline lesions may also spread bilaterally because of crossover lymphatics.

Reference: Snell's Clinical Anatomy by Regions, 10th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

Written and medically reviewed by the StethoPrep medical team.