THE EARLY diagnosis and management of carcinoma of the oral cavity and pharynx continues to present a great challenge. Carcinoma in an early stage of development is hard to detect because the lesion may be impalpable and the color changes not very different from the color of the surrounding mucosa. When the tumor is still intraepithelial, the only evidence may be an area of "erosion" where the thin covering layer of keratin or flattened cells is missing. Because carcinoma in the oral cavity, pharynx, and larynx is often multicentric in origin, it is common to find satellite tumors adjacent to the main tumor mass; the satellite tumor may be inconspicuous and overlooked during definitive therapy. Many carcinomas of the oral cavity start out as surface lesions which spread over the mucosa much more than they infiltrate1; the margins of the tumor may be hard to define, especially if there is