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.