Sublingual solid mass lesion

Case contributed by Mohamed Saber
Diagnosis probable

Presentation

Mouth floor swelling with pain

Patient Data

Age: 30 years
Gender: Female

Right-sided mouth floor / sublingual space well defined ovoid lesion centered upon the sublingual gland, indenting the right genioglossus muscle and abutting the inner cortex of the mandible. It measures 2.5x1.5x2.5 cm, it presents slight hypodensity relative to the adjacent muscle

No associated bony destruction or aggressive changes

Right maxillary sinus small retention cyst

mri

Right-sided mouth floor / sublingual space well defined ovoid lesion centered upon the sublingual gland, indenting the right genioglossus muscle and abutting the inner cortex of the mandible. It measures 2.5x1.5x2.5 cm, it elicits intermediate signal intensity in T1 and high signal in T2 with moderate homogenous enhancement in the post-contrast study

No associated bony destruction or aggressive changes

Right maxillary sinus small retention cyst

Bilateral cheek subcutaneous fillers

Case Discussion

Here is a case of a sublingual solid mass lesion. The CT picture is similar to cystic lesions (ranula, retention cyst, epidermoid cyst, others) that are much more common than solid lesion in this location, however,  MRI was superior in demonstration of the lesion signal and enhancement

Differential diagnosis includes:

  • Pleomorphic adenomas of the salivary glands are benign tumors present as well-circumscribed masses, most commonly located within the parotid gland, hypoechogenic on ultrasound, and bright on T2WI with homogeneous enhancement on MRI. The sublingual gland is the least common salivary gland to be involved 0.5%
  • Hemangioma: considering intense bright signal in T2

Unfortunately, no available histopathological proof

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