imaging of mass lesions of tongue abstract no : 1171
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IMAGING OF MASS LESIONS OF TONGUE
ABSTRACT NO : 1171
AIMS & OBJECTIVES
• To demonstrate the role of Multi detector computed tomography and Magnetic Resonance Imaging in detection of mass lesions of tongue .
• To demonstrate their role in pre operative diagnosis and management.
MATERIALS & METHODS
• 29 patients with mass lesions in tongue are evaluated with CT or MRI for a period of 7 months from March 2014 till October 2014.
• CT - 64 Slice GE Contrast enhanced Axial, Coronal and Sagittal images
• MRI - 1.5 Tesla GE 16 channel MRI. Three plane T1 , T2 FS are basic sequences.
TECHNIQUE-PUFF CHEEK
RESULTS AND DISCUSSION
83%
17%
TONGUE LESIONS
NORMAL
75%
8%
4%4%
4%
4%
SCC AVM HEMANGIOMA
THYROGLOSSAL CYST MACROGLOSSIA LIPOMA
scc
0 -20
21 -40
41 -60
> 60
0 3 6 9 12
MALE FEMALE
DEMOGRAPHIC DISTRIBUTION
SQUAMOUS CELL CARCINOMA
• Squamous cancers of gingivobuccalregion,oral tongue and retromolar trigone are common oral cancers in our country.
• Among these carcinoma tongue is the second most common .
• Lateral border- most common site.
• Staging is important in the management.
11
510
0 - 20
21 - 40
41 - 60
> 60 YEARS
AGE
SQUAMOUS CELL CARCINOMA OF TONGUE
ETIOLOGY
ASSOCIATION 13NO ASSOCI-ATION 5
SQUAMOUS CELL CARCINOMA
MALE72%
FEMALE28%
GENDER
LEFT76%
RIGHT24%
SIDE OF THE LESION
LATE
RAL A
SPEC
T
CROSS M
IDLINE
BONE
INVA
SION
RETROM
OLAR T
RIGONE
ANTE
RIOR 2
/3 R
D
POST
ERIO
R 1/3
RD
PSEU
DO ANEU
RYSM
10
4
8
12
16
PRESENTATIONS
PRESENTATIONS OF SQUAMOUS CELL CARCINOMA
TUMOR
T1T2
T3 T4
56 YEAR OLD MALE PATIENT WHO IS A KNOWN CASE OF SQUAMOUS CELL CARCINOMA OF TONGUE CAME FOR FOLLOW UP EVALUATION
70 YEAR OLD PATIENT CAME WITH COMPLAINTS OF DIFFICULTY IN SWALLOWING AND BREATHING
64 YEAR OLD MALE PATIENT CAME WITH PAIN AND BURNING SENSATION OF TONGUE; PAST HISTORY OF BIOPSY
14 YEAR OLD FEMALE PATIENT WITH C/O SWELLING ON THE TIP OF TONGUE SINCE BIRTH , PROGRESSIVELY INCREASING FROM BIRTH
PRE AND POST
49 YEAR OLD MALE PATIENT CAME WITH COMPLAINTS OF SUBMUCOSAL BULGE
*3 YEAR OLD PATIENT BROUGHT BY MOTHER WITH COMPLAINTS OF SWELLING IN TONGUE SINCE TWO
YEARS OF AGE.
54 YEAR OLD MALE PATIENT CAME WITH COMPLAINTS OF SWELLING OF TONGUE
67 YEAR MALE CAME WITH COMPLAINTS OF SWELLING OF TONGUE
T1 T2W
FAT SAT
CONCLUSION
• Though MR is the sensitive imaging modality for tongue evaluation , CT is most commonly used in preoperative assessment and post operative surveillance.
• When CT and MRI are combined together the sensitivity and specificity of delineating tongue lesions is increased.
TAKE HOME MESSAGE
• CT -cortical erosions.
• MRI -soft tissue extension, bone marrow involvement and peri neural spread.
• CT and MRI are complementary in evaluating tongue lesions.
REFERENCES1) Yasunori Ariyoshi, Masashi Shimahara,Yasuo Uesugi, Isamu Narabayashi Magnetic
Resonance Imaging of the Normal Tongue:Qualitative Evaluation of Fat-suppressed Contrast Enhanced Images. Bulletin of the Osaka Medical College 49 1, 2 21-28, 2003.
2) Sunita Tibrewala, Sudeep Roplekar, Ravi Varma. Computed Tomography Evaluation of Oral Cavity and Oropharyngeal Cancers. Otorhinolaryngology Clinics: An International Journal, May-August 2013;5(2):51-62
3) Mallayya Pujari ,Shraddha Bahirwani , Balaji P,Rachna kaul ,Bina Shah, Deepak Daryani .Arteriovenous Malformation of Tongue: A Case Report and Review of Literature .Journal of Indian Academy of Oral Medicine and Radiology, April-June 2011;23(2):139-142.
4) Lori L. Baker, William P. Dillon, Grant B. Hieshima, Christopher F. Dowd, and Ilona J . Frieden.Hemangiomas and Vascular Malformations of the Head and Neck: MR Characterization. AJNR 14:307-31 4, Mar/ Apr 1993 0 195-61 08/93/ 1402-0307.
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