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Ultrasound images in the right half of the thyroid gland of an 81-year-old man with squamous cell carcinoma on the right side of the tongue and metastasis in one of the superior internal jugular lymph nodes.  A 2.6-cm echogenic mass (arrows) in the right half of the thyroid gland is shown.
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fig9: Ultrasound images in the right half of the thyroid gland of an 81-year-old man with squamous cell carcinoma on the right side of the tongue and metastasis in one of the superior internal jugular lymph nodes. A 2.6-cm echogenic mass (arrows) in the right half of the thyroid gland is shown.

Mentions: When surveying the metastasis in cervical lymph nodes in patients with oral cancer, we suggested the clinical significance of additional ultrasonographic examination for thyroid glands [45]. In that report, we elucidated that over 30% of patients with oral squamous cell carcinoma have a relatively high rate of abnormal findings in the thyroid gland that can be detected by US. In addition, as subject age increased, the rate of detection of abnormal thyroid gland findings on US significantly increased; this increase was particularly prominent for men. In one case, a 2.3-cm echogenic mass in the right side of the thyroid gland was detected in a patient with a lesion on the right side of the tongue that was diagnosed as squamous cell carcinoma by biopsy in another hospital and one metastatic lymph node was also determined (Figure 9). Moreover, particular attention should be paid to thyroid gland abnormalities if patients had oral squamous cell carcinoma on the floor of the mouth or in the maxillary gingiva. Moreover, a relative high rate of patients showed enlargement in the size of the lesion upon followup examination with US. Therefore, when such findings appeared during followup examinations, we promptly instruct patients to consult specialists to further search for lesions in the thyroid gland.

Advanced Clinical Usefulness of Ultrasonography for Diseases in Oral and Maxillofacial Regions

Wakasugi-Sato N, Kodama M, Matsuo K, Yamamoto N, Oda M, Ishikawa A, Tanaka T, Seta Y, Habu M, Kokuryo S, Ichimiya H, Miyamoto I, Kito S, Matsumoto-Takeda S, Wakasugi T, Yamashita Y, Yoshioka I, Takahashi T, Tominaga K, Morimoto Y - Int J Dent (2010)

Bottom Line: Various kinds of diseases may be found in the oral and maxillofacial regions and various modalities may be applied for their diagnosis, including intra-oral radiography, panoramic radiography, ultrasonography, computed tomography, magnetic resonance imaging, and nuclear medicine methods such as positron emission tomography.Doppler ultrasound images taken in the B-mode can provide vascular information associated with the morphology of soft tissues.In the present article, we introduce three new applications of ultrasonography: guided fine-needle aspiration, measurement of tongue cancer thickness, and diagnosis of metastasis to cervical lymph nodes.

Affiliation: Department of Oral Diagnostic Science, Kyushu Dental College, Kokurakita-ku, Kitakyushu, Fukuoka 803-8580, Japan.

ABSTRACT
Various kinds of diseases may be found in the oral and maxillofacial regions and various modalities may be applied for their diagnosis, including intra-oral radiography, panoramic radiography, ultrasonography, computed tomography, magnetic resonance imaging, and nuclear medicine methods such as positron emission tomography. Of these modalities, ultrasound imaging is easy to use for the detection of noninvasive and soft tissue-related diseases. Doppler ultrasound images taken in the B-mode can provide vascular information associated with the morphology of soft tissues. Thus, ultrasound imaging plays an important role in confirming the diagnosis of many kinds of diseases in such oral and maxillofacial regions as the tongue, lymph nodes, salivary glands, and masticatory muscles. In the present article, we introduce three new applications of ultrasonography: guided fine-needle aspiration, measurement of tongue cancer thickness, and diagnosis of metastasis to cervical lymph nodes.

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