Unspecified congenital anomaly of circulatory system [747.9] / Swelling, mass, or lump in head and neck [784.2], Reason for Study: ^Reason: eval for vascular malformation History: mass along submandibular There is a lobulated large mass measured about 31.4 mm x 49.7 mm x 31.8 mm on the left sublingual space.The lesion shows intermediate signal intensity on T1 and high signal intensity on T2 with restricted diffusion.There is no evidence of contrast enhancement on post Gad T1 weighted image.The mass is mainly located on the left side floor of mouth and appears to be extended toward submandibular space. There is no evidence of sizable neck lymphadenopathy.Above described finding suggest possibility of plunging ranula with complicated or high protein content. Differential diagnosis include minor salivary gland epidermoid, tumorous condition or inflammatory condition.Covered brain and orbit appear to be normal.The paranasal sinuses and mastoid air cells are clear.3D MRA neck post-gadolinium images with maximum intensity projections of the cervical vasculature demonstrate normal flow enhancement in a normal aortic arch origin of the right brachiocephalic, left common carotid, and left subclavian arteries. The vertebral artery origins are normal. There is normal flow enhancement through the bilateral common carotid, carotid bifurcations, internal/external carotid, and vertebral arteries. Prominent bilateral supraophthalmic veins without other imaging evidence of cavernous sinus congestion, thus this indicate normal range of prominency.
1. Left mouth floor cystic mass extending toward left submandibular space indicating plunging ranula. Differential diagnosis include epidermoid, tumorous condition or inflammatory condition.2. Normal neck MR angiography. 