Male, 67 years old, with right base of tongue mass, tongue deviated to the right, throat and tongue pain. Brain:No evidence of parenchymal mass effect or edema is seen. No pathologic parenchymal or extra-axial enhancement is detected. There are a number of scattered small foci of FLAIR hyperintensity including within the anterior temporal lobes and the right superior frontal gyrus which are unchanged and nonspecific. Innumerable foci of susceptibility are redemonstrated with particular involvement of the bilateral frontal lobes, the inferior parietal lobes and the temporal lobes, similar to that seen on the prior examination. No evidence of acute intracranial hemorrhage is seen. No abnormal extra-axial collections are detected. Ventricular size morphology are within normal limits.Neck:Image quality is limited by motion artifact. An enhancing mass is redemonstrated centered on the right tongue base with invasion of the intrinsic tongue musculature and floor of mouth. The lesion does extend across midline to involve the left tongue base to some degree. Compared to the prior examination, it appears that the lesion has increased in size, now measuring up to 38 mm in maximal axial length, previously approximately 28 mm when measured similarly. As before, tumor partially effaces the vallecula.The remainder of the aerodigestive mucosa is within normal limits. No pathologic adenopathy is detected by size criteria. The salivary glands and the thyroid appear to be free of focal lesions. Multilevel cervical spondylosis is demonstrated superimposed on a congenitally slender canal.
1.Probable increase in size of the right tongue base/floor of mouth tumor.2.No pathologic adenopathy is detected in the neck.3.No evidence of intracranial metastases is seen.4.Numerous scattered foci of brain parenchymal susceptibility are redemonstrated. These lesions are compatible with chronic microhemorrhage, perhaps related to amyloid angiopathy.