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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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