T4N2c squamous cell carcinoma of the floor of the mouth and ventral tongue status post induction chemotherapy and radiotherapy. There is diffuse stranding and thickening involving the soft tissues of the lower face/upper neck, including the larynx, which is likely treatment-related. The midline enhancing, infiltrative mass involving the floor of the mouth and the ventral aspect of the tongue has not significantly changed in overall size, but is more T2-hyperintense and less enhancing centrally. The sublingual glands are indistinct from the tumor. The associated reference left level 1B pathologic lymph node is also not significantly changed in size, measuring 14 x 20 mm compared to 13 x 20 mm previously, but is more heterogeneous. The reference right level 3 lymph node measures 12 mm x 14 mm, previously 10 mm x 13 mm previously. A more inferiorly located right level 3 lymph node measures 10 x 13 mm, previously 9 x 14 mm. The submandibular glands, parotid glands, and thyroid are unchanged. The osseous structures are unchanged. There is a right internal jugular venous catheter.
The infiltrative tumor involving the floor of the mouth and the ventral tongue as well as the associated lymph adenopathy have not significantly changed in size, but are more necrotic.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.