Lymph node involvement
In carcinoma of the lip, the submental and submandibular lymph nodes are taken and increase in size. The patient may report masses under the chin and the neck region that will be felt under local examination. The lymph from the anterior two-thirds of the tongue drains into the same side mid and upper cervical nodes except for the tip of the tonge, which drains into the submental lymphatics. Lymph from the posterior one-third drains into the lymphatic ring around the oropharynx (known as the ring of Waldeyar), and then to upper deep cervical lymph nodes. Hard Palate carcinoma and gingival carcinoma metastasizes to the submandibular and upper jugular nodes. Cancer of the floor of the mouth can also metastasize to submandibular lymphatics.