How would you manage a high grade acinic cell carcinoma of the parotid with isolated recurrence in the ipsilateral neck s/p salvage resection?  

High grade acinic cell is practically a misnomer. At any rate, badly behaved. If really high grade at the outset, neck should have been irradiated. Now ipsilateral neck. Tempted to include the primary site. Contralateral neck low risk.

For this patient with a neck recurrence and (presumably) no evidence of primary site recurrence who had been treated with RT previously to the parotid bed, I would treat ipsilateral neck levels IB, II, III, IV, and V. While IB coverage may be controversial, if the recurrence was in level II, I would...