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Clinical Problem Solving: Radiology |

Radiology Quiz Case 1

Oscar Calderon, MD; David G. Lott, MD; Robert R. Lorenz, MD
Arch Otolaryngol Head Neck Surg. 2008;134(5):554. doi:10.1001/archotol.134.5.554.
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A 39-year-old woman presented with a submucosal, midline, floor of the mouth lesion that had grown over 1 year. There was no associated pain, numbness, or tongue weakness, although family members had noted increased snoring. There was no history of alcohol or tobacco abuse. Head and neck examination revealed slight disarticulation, external enlargement of the submental area, and a large lesion in the midline of the floor of the mouth that pushed the tongue superiorly but did not involve the overlying mucosa. The submandibular glands and Wharton ducts functioned properly and were not involved. The tongue was sensate and mobile. The findings of the rest of the otolaryngologic examination were unremarkable. A computed tomographic scan with contrast demonstrated a large, homogeneous, low-density midline mass without septations or calcifications superior to the mylohyoid muscle (Figure 1[arrow] and Figure 2). There were no lesions in the area of the hyoid bone. Both sublingual and submandibular glands were normal and separate from the lesion.

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The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
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