Tongue and floor of mouth neoplasm

Case contributed by Varun Babu

Presentation

Lesion invading right anterolateral tongue and right floor of mouth.

Patient Data

Age: 60 years
Gender: Male

T1 hypointense, T2 and STIR hyperintense, diffusion restricting, predominantly peripherally enhancing mass lesion epicentered in right anterolateral tongue, invading genioglossus without crossing midline, invading hyoglossus and entire sublingual space, and involving ipsilateral mylohyoid. No evident mandibular involvement. Few subcentimetric discrete lymph nodes in right level Ib.

Annotated image

Annotated extent of the lesion. 

Case Discussion

Knowledge of the anatomy of the oral cavity is imperative to understand the site of origin of the neoplasm, the pattern of spread and enables documenting the stage of the disease. Herein we have an oral cavity neoplasm that appears to originate from the anterior tongue to spread into the floor of mouth invading structures as described. When multiple spaces and fascial planes are involved, assessment of crossing of mid line and bony involvement is mandatory. 

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