37-year-old female with history of stage IV T2N2bM0 squamous cell carcinoma of the left lateral tongue on protocol 12-1712 ended induction on 7/8. Evaluate for interval change. The previously described anterior left oral tongue tumor has decreased in size and become less well-defined. The lesion now measures up to 35 mm in the coronal plane (image 16 series 501), previously 40 mm. As before, the lesion probably involves the left submental space, but does not invade into deeper structures. No abnormality of the adjacent mandible is seen.The previously referenced necrotic left level II node or nodal aggregate is redemonstrated now measuring 47 x 43 mm (image 22 series 901), previously 35 x 30 mm. As before, abnormal infiltrative enhancement contiguous with this large necrotic aggregate does involve the adjacent carotid space. A previously referenced left level Ib lymph node measures 13 x 12 mm (image 17 series 901), previously 16 x 12 mm. The left lateral retropharyngeal lymph node measures 8 x 4 mm (image 30 series 901), previously 7 x 5 mm. The right level IIa reference node measures 10 x 7 mm (image 20 series 901), previously 10 x 7 mm.The remaining neck lymph nodes show no significant interval change. There is a cystic right thyroid nodule that measures up to 9 mm and is unchanged. There are small maxillary sinus retention cysts. There are also secretions in the left sphenoid sinus. The orbits and imaged intracranial structures are unremarkable. There is a small posterior disc-osteophyte complex at C5-C6 that mildly indents the spinal cord. Ill-defined enhancement within the C5 vertebral body is unchanged and nonspecific but may represent a hemangioma.
1.Interval decrease in the size of the left anterior oral tongue tumor.2.The dominant left level II necrotic nodal aggregate has increased in size. While some of this increase represents expansion of the necrotic/cystic core, there does also appear to be a thicker rind of enhancing tissue as well.3.Additional cervical lymph nodes are stable or reduced in size as above.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.