Female, 38 years old, with history of T2 and one squamous cell cancer of the right tongue status post partial glossectomy, neck dissection and radiation followed by recurrence. Image quality is degraded by motion artifact which is present on all sequences despite multiple repeat attempts. There is also loss of signal in the anterior inferior neck of uncertain etiology. Within these limitations, the following observations are made.Anatomic distortion of the tongue is seen with a defect involving the right anterior aspect, possibly postsurgical in nature. The remainder of the anterior oral tongue is thickened and abnormally T2 hyperintense. This tissue measures up to 48 x 33 mm (image 38 series 701). This tissue extends superiorly to encompass all of the anterior oral tongue, and it extends inferiorly to some degree into the floor of mouth. Posteriorly the oral tongue demonstrates normal morphology and signal intensity.A presumed submental lymph node is poorly visualized on the present examination. No definite additional pathologic adenopathy is seen, though for reasons discussed above, the concurrent and prior CTs provide a better assessment in this regard.Extensive presumably treatment related findings are seen including subcutaneous reticulation and infiltrative edema which affects the soft tissues of both sides of the neck. There is a sizable retropharyngeal effusion. The supraglottic laryngeal mucosa and the soft palate are edematous.No focal lesions of the parotid glands are suspected. The submandibular glands are not well delineated on this study. The thyroid is somewhat obscured by artifact and not adequately assessed. Patchy airspace opacities are seen in the right upper lung.
Image quality is significantly limited by motion artifact and loss of signal affecting the anterior inferior neck. Postoperative findings are seen in the anterior right tongue. The remainder of the anterior oral tongue is thickened and demonstrates pathologic T2 signal compatible with extensive local residual or recurrent tumor. This tumor fills the anterior oral tongue and potentially extends down into the floor of mouth.Extensive presumed treatment related findings are again seen including diffuse infiltrative edema of the soft tissues of the neck, a retropharyngeal effusion, and edema of the aerodigestive mucosa. Adenopathy is better assessed on concurrent and prior CTs.