Jerry Fulton

On March 13th, 2017 Dad woke up with swelling and tenderness at his right neck/under his jaw.  He was seen by his Primary Care Provider and treated for an infection in the lymph nodes that was likely related to a very small "skin lesion" that had just presented at his right temporal region of the forehead.   The antibiotics treated the infection and swelling in the lymph nodes very well, but the skin lesion on his forehead began to grow so he was referred to a dermatologist for further diagnostic evaluation. 


In early April, Dad was seen by a Dermatologist in Jackson who biopsied the lesion with positive results that favored metastatic squamous cell carcinoma which usually means a skin cancer that has spread to another part of the body or the lymphatic system. This led to a referral to an Ear Nose and Throat surgeon and subsequent testing with CT scans and a PET scan showed a nodule at his right parotid gland which is a gland at your lower jaw/upper neck that secretes saliva.  This led to an ultrasound guided needle biopsy of the nodules in his parotid gland that were likely consistent with the previously biopsied squamous cell carcinoma from the forehead. 


Dad was initially scheduled to have total excision of the right parotid gland and excision of the R temporal (forehead) lesion on May 11, 2017 followed by radiation therapy to the neck/jaw. However, after further review of the biopsies by pathologists at University Medical Center in Jackson, there was concern for this cancer not being a "skin cancer" but a squamous cell carcinoma with unknown primary origin which basically means that the cancer showing on his head and neck were not the primary source but the doctors in Jackson did not know where it was coming from.  Squamous cell carcinoma with unknown primary origin is a very rare and aggressive type of cancer, and because of this it was felt that he could best be treated at a specialty center or academic center such as MD Anderson in Houston where they see  and treat rare cancers often and have a multitude of resources and databases available to utilize in his treatment. 


So, on May 31, 2017 we went to Houston.  We met with a head and neck surgeon, an oral surgeon, and had CT scans of the head, neck, and chest with plans for having the previously planned surgery on June 1, 2017.  Dad's CT scans confirmed that his cancer is confined to his head and parotid gland and that there was not another source that was hiding in his body somewhere.  This was a blessing to hear.  However, after meeting with our surgeon and going over Dad's previous testing and biopsies, our team at MD Anderson was suspicious that Dad's cancer was not a squamous cell carcinoma but possibly an angiosarcoma.  An angiosarcoma is a  very rare soft tissue cancer that arises from the lining of the blood vessels. It is often misdiagnosed as a squamous cell carcinoma because it is not seen often.   So this will be very important to determine as the treatment plan will be initiated differently depending on which type of cancer it is.  An angiosarcoma will most likely require 6 months of chemotherapy treatment before surgery in order to try to shrink the tumor size down so that the surgeons can assure clean margins when they go in to surgically remove the cancer.  A squamous cell carcinoma would be treated with surgery first, then radiation.  


As of now - June 2, 2017, we are back in Yazoo City awaiting the pathologists at MD Anderson to personally review the tissue samples from Dad's biopsies to confirm which type of cancer we are dealing with.  We are hoping to get a final diagnosis this coming week, and will plan to return to Houston in the next 1-2 weeks, depending on which type of cancer we are dealing with.  We are very impressed with the care that Dad received in Houston and the Team that we have leading and managing his care.  [His surgeons and staff have met my expectations 100% and that says a lot coming from a provider with extremely high standards for her Dad's care :)].  Please continue to keep Dad in your thoughts and prayers. There is truly power in numbers and we feel the support more than you know! Will update as soon as we know something.