Presentation
Biopsy proven squamous cell carcinoma opted for alternative Indian medicine treatment, has returned for a review study after 3 years. No previous images available for comparison.
Patient Data
A large mass lesion that is poorly heterogeneously enhancing appearing T1 dark, T2 bright, is seen epicentered in the right half of floor of mouth in relation of retromolar trigone extending along right alveolar margin anteriorly, invading the inner cortex of mandible, medially invading base of tongue, entire soft palate and uvula, posteromedially invading posterolateral oropharyngeal wall, epiglottis, right aryerpiglottic fold and preepiglottic fat.
Ipsilateral spread to level II, III and IV lymph nodes seen.
Correlative CT identfies and demonstrates the extent of mandibular erosion.
Case Discussion
Unfortunately, the patients earlier scans were unavailable. This patient opted for alternative Indian medicine 3 years ago when this diagnosis was first made. The present local extensive spread of the lesion with ipsilateral cervical lymphadenopathy as well as with bony invasion is a sign of progression of disease and non-responsiveness to 'alternative' medicine. Respiratory motion artefacts are seen in the MRI study due to the old age of the patient and relative discomfort of having this large lesion in the oral cavity.