T4N2c floor of mouth and ventral tongue squamous cell carcinoma status post biopsy and cycle 1/5 of TFH. There is interval appearance of a fluid-filled defect in the enhancing right anterior oral tongue mass, with extension across the midline and into the floor of mouth. The mass measures up to approximately 35 mm, which is not significantly changed. There is an enlarged, heterogeneously enhancing left level 1B lymph node that measures 16 x 21 mm in axial cross-section, previously 10 x 17 mm. There is also an enlarged and necrotic right level 2B lymph node that measures 13 x 16 mm, previously 7 x 12 mm. In addition, there has been increase in size of a right level 3 lymphadenopathy, which measures 16 x 25 mm, previously 9 x 13 mm. Furthermore, although not particularly large, the right level 1A lymph node appears to be hyperenhancing and is slightly larger than previously, now measuring 8 x 12 mm. The thyroid and salivary glands appear to be intact. The larynx appears to be unremarkable. The orbits and intracranial structures are grossly unremarkable. There is multilevel degenerative spondylosis of the cervical spine, including a disc-osteophyte complex at C5-6 that mildly impinges upon the spinal cord.
1. Interval biopsy changes in the oral cavity mass, but otherwise no significant interval change in size of the tumor.2. Interval increase in size of bilateral cervical lymphadenopathy.