Newly diagnosed tongue mass, eval extent of lesion. There is a heterogeneously enhancing mass in the right floor of mouth with possible involvement of the overlying right mylohyoid muscle and oral tongue. The tumor extends across the midline measures up to approximately 35 mm. In addition, there is surrounding ill-defined T2 hyperintensity and enhancement that extends towards the tongue base, which also appears diffusely enlarged. However, the overlying mandible appears to be intact. Although not particularly enlarged based on size criteria, right level 1B and 2B lymph nodes appear hyperenhancing. There is a heterogeneous right level 3 lymph node that measures 11 x 13 mm. There is also a prominent left level 1B lymph node that measures 12 x 15 mm in axial cross section. The thyroid and salivary glands appear to be intact. The larynx appears to be unremarkable. The orbits and intracranial structures are grossly unremarkable. There is multilevel degenerative spondylosis of the cervical spine, including a disc-osteophyte complex at C5-6 that mildly impinges upon the spinal cord.
1. A heterogeneously enhancing mass in the right floor of mouth and oral tongue with extension across the midline measures up to 35 mm likely represents a squamous cell carcinoma. Ill-defined enhancement that extends towards a prominent, likely hyperplastic lingual tonsil may represent peritumoral inflammation rather than tumor infiltration.2. Bilateral cervical lymphadenopathy likely, at least in part, represents metastatic disease.