Female, 46 years old, with history of T4a N2c M0 oral tongue cancer. Mild deformity of the oral tongue is seen which may be posttreatment in nature. However, no tumor-like lesion is identified within the tongue or floor of mouth.Findings compatible with prior right rim mandibulectomy are seen. Abnormal T2 hyperintense signal and mild hyperenhancement is evident within the residual right mandible. In addition, there appears to be progressive erosion of the buccal mandibular cortex centered at approximately the level of the right mandibular foramen (see image 28 series 901).The mucosa of the pharynx and supraglottic larynx is edematous compatible with treatment change. No pathologic adenopathy is detected in the neck by size criteria. The salivary glands and the thyroid are unremarkable. Bone marrow signal characteristics are otherwise unremarkable. Mild cervical degenerative disc disease is seen.
1.Signal abnormality, mild hyperenhancement and progressive cortical erosion are seen within the residual right mandible centered at approximately the level of the mandibular foramen. The differential for this finding would include osteoradionecrosis, infection and perineural tumor spread. Further evaluation with CT may better characterize the osseous features of the abnormality.2.No evidence of primary tumor recurrence in the tongue or floor of mouth. No pathologic adenopathy is detected in the neck.