Clinical question: Rule out malignant otitis, rule out abscess. Signs and symptoms: Right ear pain. Enhanced CT of the maxillofacial:Examination demonstrates a low-density mass within the left submandibular gland measuring 21.5 mm x 15.2-mm in trans-axial dimensions on image 14 and 32.3-mm in cranial -- cephalad axis on sagittal reformatted image 36. There is no detectable enhancement of this lesion. The left submandibular gland is expanded and surrounds this lesion however it be done CT of the remaining gland remains within normal limits. There is no evidence of any calcification with this finding. Recommend further follow all with an MRI examination for better characterization of this lesion. The finding although could represent a says possibility of a tumor is high and should be further evaluated. There is no associated lymphadenopathy with this finding on this limited view of upper neck. There is also no evidence of any inflammatory changes of the adjacent fascial planes. No evidence of any mass effect on the airway and no evidence of any osseous or cartilaginous erosion.Images through the oral cavity and floor of the mouth are otherwise unremarkable.Normal appearing bilateral parotid glands.Images through the skull base and bilateral petrous bones demonstrate well pneumatized mastoid air cells and middle ear cavities as well as external auditory canals bilaterally. The ossicular chain are unremarkable. There is no evidence of any inflammatory changes in the periauricular region. The external year and has normal density and morphology. The TMJs are well-visualized and unremarkable. The sphenoid sinus/sphenoid bone is within normal limits. Minimal chronic sinus disease of bilateral maxillary sinuses are noted. No detectable abnormality at the level of nasal findings, oral findings is detected.
Examination demonstrates a low-density nonenhancing mass within the left submandibular gland measuring 21.5 x 15 times 32.3-mm in size. Follow up with an MRI examination is recommended. This lesion is not associated with any enhancement, inflammatory changes, abnormal calcification within the gland or the lesion and no evidence of any dilated ducts within the gland or any visible adenopathy on this exam. The left submandibular gland beyond the mass/cyst has normal density and pattern of enhancement. Enhanced CT of the maxillofacial is otherwise entirely unremarkable and in particular no evidence of otitis or mastoiditis is detected.