IMAGING OF MASS LESIONS
OF TONGUE
ABSTRACT NO : 1171
AIMS & OBJECTIVES
• To demonstrate the role of Multi detector computed
tomography and Magnetic Resonance Imaging in
detection of mass lesions of tongue .
• To demonstrate their role in pre operative diagnosis
and management.
MATERIALS & METHODS
• 29 patients with mass lesions in tongue are
evaluated with CT or MRI for a period of 7 months
from March 2014 till October 2014.
• CT - 64 Slice GE Contrast enhanced Axial, Coronal
and Sagittal images
• MRI - 1.5 Tesla GE 16 channel MRI. Three plane T1
, T2 FS are basic sequences.
TECHNIQUE-PUFF CHEEK
RESULTS AND DISCUSSION
NORMAL
17%
TONGUE LESIONS
83%
SCC
HEMANGIOMA
MACROGLOSSIA
AVM
THYROGLOSSAL CYST
LIPOMA
4%
4%
4%
4%
8%
75%
scc
DEMOGRAPHIC DISTRIBUTION
MALE
FEMALE
0 -20
21 -40
41 -60
> 60
0
3
6
9
12
SQUAMOUS CELL CARCINOMA
•
Squamous cancers of gingivobuccalregion,oral
tongue and retromolar trigone are common oral
cancers in our country.
•
Among these carcinoma tongue is the second
most common .
•
Lateral border- most common site.
•
Staging is important in the management.
SQUAMOUS CELL CARCINOMA OF TONGUE
ETIOLOGY
AGE
1
1
0 - 20
21 - 40
5
10
41 - 60
> 60
YEARS
ASSOCIATION
13
NO
ASSOCIATION
5
SQUAMOUS CELL
CARCINOMA
GENDER
SIDE OF THE LESION
RIGHT
24%
FEMAL
E
28%
MALE
72%
LEFT
76%
PRESENTATIONS OF SQUAMOUS CELL
CARCINOMA
16
14
12
10
8
6
4
2
0
PRESENTATIONS
T1
T2
TUMOR
T3
T4
56 YEAR OLD MALE PATIENT WHO IS A KNOWN CASE OF SQUAMOUS CELL
CARCINOMA OF TONGUE CAME FOR FOLLOW UP EVALUATION
70 YEAR OLD PATIENT CAME WITH COMPLAINTS OF DIFFICULTY IN
SWALLOWING AND BREATHING
64 YEAR OLD MALE PATIENT CAME WITH PAIN AND BURNING
SENSATION OF TONGUE; PAST HISTORY OF BIOPSY
14 YEAR OLD FEMALE PATIENT WITH C/O SWELLING ON THE TIP OF
TONGUE SINCE BIRTH , PROGRESSIVELY INCREASING FROM BIRTH
PRE AND POST
49 YEAR OLD MALE PATIENT CAME WITH COMPLAINTS
OF SUBMUCOSAL BULGE
*3 YEAR OLD PATIENT BROUGHT BY MOTHER WITH
COMPLAINTS OF SWELLING IN TONGUE SINCE TWO
YEARS OF AGE.
54 YEAR OLD MALE PATIENT CAME WITH COMPLAINTS OF SWELLING OF
TONGUE
67 YEAR MALE CAME WITH COMPLAINTS OF
SWELLING OF TONGUE
FAT SAT
T1
T2W
CONCLUSION
•
Though MR is the sensitive imaging modality for
tongue evaluation , CT is most commonly used in
preoperative assessment and post operative
surveillance.
•
When CT and MRI are combined together the
sensitivity and specificity of delineating tongue
lesions is increased.
TAKE HOME MESSAGE
•
CT -cortical erosions.
•
MRI -soft tissue extension, bone marrow
involvement and peri neural spread.
•
CT and MRI are complementary in evaluating
tongue lesions.
REFERENCES
1)
Yasunori Ariyoshi, Masashi Shimahara,Yasuo Uesugi, Isamu Narabayashi Magnetic
Resonance Imaging of the Normal Tongue:Qualitative Evaluation of Fat-suppressed
Contrast Enhanced Images. Bulletin of the Osaka Medical College 49 1, 2 21-28, 2003.
2)
Sunita Tibrewala, Sudeep Roplekar, Ravi Varma. Computed Tomography Evaluation of
Oral Cavity and Oropharyngeal Cancers. Otorhinolaryngology Clinics: An International
Journal, May-August 2013;5(2):51-62
3)
Mallayya Pujari ,Shraddha Bahirwani , Balaji P,Rachna kaul ,Bina Shah, Deepak Daryani
.Arteriovenous Malformation of Tongue: A Case Report and Review of Literature
.Journal of Indian Academy of Oral Medicine and Radiology, April-June 2011;23(2):139142.
4)
Lori L. Baker, William P. Dillon, Grant B. Hieshima, Christopher F. Dowd, and Ilona J .
Frieden.Hemangiomas and Vascular Malformations of the Head and Neck: MR
Characterization. AJNR 14:307-31 4, Mar/ Apr 1993 0 195-61 08/93/ 1402-0307.