Newly diagnosed base of tongue squamous cell carcinoma: evaluate for T stage of primary: right ear/tongue pain. There is an enhancing mass centered in the right tongue base that measures up to 30 mm. The tumor also extends into the glossotonsillar sulcus and posterior lateral oral tongue and floor of mouth. However, the masseter and parapharyngeal spaces are intact. There is also sheet-like high T2 signal and enhancement along the left lateral oral tongue. There is necrotic appearing right level 2 and 3 lymphadenopathy. For example, a right level 2A lymph node measures 14 x 22 mm in axial section, a more inferior right level 2B lymph node measures 9 x 11 mm in axial section, and a right level 3 lymph node measures 6 x 10 mm in axial section. There is no definite significant lymphadenopathy in the left neck, at least based on size criteria. The salivary glands and thyroid appear unremarkable. There is mild degenerative lower cervical spondylosis. There appears to be atherosclerotic plaque at the bilateral carotid bifurcations. The orbits and imaged intracranial structures are grossly unremarkable.
1. A mass centered in the right tongue base that measures up to 30 mm. 2. Multiple necrotic appearing right level 2 and 3 lymphadenopathy is compatible with metastatic disease. 3. Sheet-like high T2 signal and enhancement along the left lateral oral tongue is nonspecific, but may be inflammatory versus less likely neoplastic. 