A thorough head and neck examination is performed which includes examination of the oral cavity, the neck and a nasoendoscopy. A biopsy of the oral cavity lesion is then performed under local anesthesia as a clinic procedure. A fine needle aspiration cytology is also performed on any neck node. Either a computed tomography scan or magnetic resonance imaging (CT or MRI) is done to evaluate the extent of the oral cavity lesion and possible neck node involvement. If the biopsy confirmed the diagnosis of cancer, then a CT scan of the thorax and liver are done as part of the staging work-up, looking for distant spread to the lungs or the liver.
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