Biopsy showed p16 negative squamous cell carcinoma, and further resection with tongue reconstruction confirmed staging at pT3 N2a (with extracapsular spread) M0.

This case is also an example of the common limitations of neck imaging on CT, with streak artefact from dental amalgam and issues relating to breath-hold. Good imaging technique relies on clear instruction with quiet breathing motion (keeping pharyngeal and laryngeal structures in a relatively neutral position).

The MRI appearances technically were better, although there was still some artefact from the dental amalgam locally.