Male, 60 years old, with history of base of tongue squamous cell carcinoma, status post bilateral neck dissection, now presenting with worsening right tongue pain. The previously seen ulcerative right oral tongue lesion appears to have completely or nearly completely healed. Only mild anatomic distortion is seen along the mucosal surface of the right oral tongue with no definite findings to suggest recurrent tumor in this location.At the left lateral base of tongue, however, there is an asymmetric area of T2 hyperintensity and subtle abnormal enhancement (see image 17 series 701, and image 24 series 1101). This area of abnormal tissue measures up to 19 mm in the axial plane and up to 17 mm in the coronal plane.Edema of the pharynx and supraglottic larynx is again seen compatible with treatment effect. Likewise, reticulation and edema within the subcutaneous tissues of the submental region are also compatible with treatment effect. No airway compromise is seen.No pathologic adenopathy is detected in the neck by size criteria. The visualized salivary glands are unremarkable as is the thyroid. The osseous structures demonstrate normal signal characteristics. Mild peripheral mucosal thickening is seen within the right maxillary sinus.
1.Complete or near complete healing of the previously seen ulcerated lesion along the right aspect of the oral tongue. No findings to suggest disease recurrence at this location are noted.2.An area of asymmetric signal abnormality and enhancement is noted at the left lateral base of tongue. The nature of this tissue is uncertain. It could be inflammatory and/or related to therapy. However, the possibility of a subtle tumor recurrence cannot be excluded.3.No pathologic adenopathy is detected in the neck. Additional therapy related findings as detailed above are fairly similar to those seen on prior CTs.