Figure 2

Superficial nodal recurrence (ipsilateral dorsolateral node) in a patient with a pT2 pN2b supraglottic larynx carcinoma. Preoperative diagnostic images did not show any suspicious superficial nodes, nor were any enlarged nodes visible in the postoperative planning computed tomography a: IMRT treatment plan, PTV1 (black line): 'build up' effect in the skin/subcutaneous region of interest (ROI, white dotted line) which was not intended to be included into the PTV1. b: posttreatment follow up computed tomography scan revealed a superficial lymph node metastasis (ROI), located in the former 'build up' area