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oropharyngeal (tongue) cancer, squamous cell carcinoma (SCC)

Lotridge JAL - MedPix (2005)

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: oropharyngeal (tongue) cancer, squamous cell carcinoma (SCC)

History: HPI: Presented with a 6 month hisotry of an asymptomatic left neck mass s/p failed course of abx therapy and two non-diagnostic FNAs. PMH: Denies any h/o CA, XRT, chemo. Denies any h/o heart dz, lung dz, DM, SLE, scleroderma, or IBD. PSH: T&A at 6; BTL at 41; Right foot surgery at 51. FHX: mom h/o uterine and colon CA; 3 sisters h/o breast CA; sister h/o uterine CA; sister h/o breast and kidney CA, died at 52; brother died of lung CA at 52 Allergies: NKDA Meds: Tylenol SHx: G4P4, postmenopausal; lifetime non-smoker, non-drinker; no significant travel or occupational exposure history ROS: Pos for globus sensation. Denies weight loss, pain, hoarseness, dysphagia, constitutional symptoms.

Findings: Neck CT: Mass adjacent to left parotid and medial to digastric measuring 2.8 (AP)x 1.6 (trans)x 4.5cm(cc). Soft tissue asymmetry superior to left vallecula - mass cannot be excluded. Neck MRI: Enhancing plaque-like mass measuring 0.9 x 2.2 x 3.4 cm at base of the tongue. A second enhancing mucosal plaque-like lesion at same level of tongue base to the right of midline measuring 1.5cm (trans) x 2.9cm (CC) x 6mm thick. Masses do not appear to extend into musculature of tongue. Hemorrhagic and necrotic lymph node in level 1 left side just inferior to mandible and deep portion of parotid lateral to carotids measuring 3 x 1.8 x 3.8cm. Second necrotic node above previous measuring 1.1 x 1.3 x 1.6cm.

Ddx: » Neoplasm - primary vs metastatic » Infection » Connective Tissue Disorder » Vasculitis » Other autoimmune disease » Other inflammatory process

Dxhow: Bx of mass at tongue base revealed squamous cell carcinoma. FNA of lymph node revealed squamous cell carcinoma.

Exam: Notable only for 3x3.5cm firm nodule in level 2 region. Nasopharyngoscope exam was benign.

No MeSH data available.


<li> Necrotic left neck nodes in level 1 region.
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MPX1514_synpic26853: <li> Necrotic left neck nodes in level 1 region.


oropharyngeal (tongue) cancer, squamous cell carcinoma (SCC)

Lotridge JAL - MedPix (2005)

<li> Necrotic left neck nodes in level 1 region.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=MPX1514&req=5

MPX1514_synpic26853: <li> Necrotic left neck nodes in level 1 region.

View Article: MedPix Image - MedPix Case

Affiliation: Uniformed Services University

ABSTRACT

Diagnosis: oropharyngeal (tongue) cancer, squamous cell carcinoma (SCC)

History: HPI: Presented with a 6 month hisotry of an asymptomatic left neck mass s/p failed course of abx therapy and two non-diagnostic FNAs. PMH: Denies any h/o CA, XRT, chemo. Denies any h/o heart dz, lung dz, DM, SLE, scleroderma, or IBD. PSH: T&A at 6; BTL at 41; Right foot surgery at 51. FHX: mom h/o uterine and colon CA; 3 sisters h/o breast CA; sister h/o uterine CA; sister h/o breast and kidney CA, died at 52; brother died of lung CA at 52 Allergies: NKDA Meds: Tylenol SHx: G4P4, postmenopausal; lifetime non-smoker, non-drinker; no significant travel or occupational exposure history ROS: Pos for globus sensation. Denies weight loss, pain, hoarseness, dysphagia, constitutional symptoms.

Findings: Neck CT: Mass adjacent to left parotid and medial to digastric measuring 2.8 (AP)x 1.6 (trans)x 4.5cm(cc). Soft tissue asymmetry superior to left vallecula - mass cannot be excluded. Neck MRI: Enhancing plaque-like mass measuring 0.9 x 2.2 x 3.4 cm at base of the tongue. A second enhancing mucosal plaque-like lesion at same level of tongue base to the right of midline measuring 1.5cm (trans) x 2.9cm (CC) x 6mm thick. Masses do not appear to extend into musculature of tongue. Hemorrhagic and necrotic lymph node in level 1 left side just inferior to mandible and deep portion of parotid lateral to carotids measuring 3 x 1.8 x 3.8cm. Second necrotic node above previous measuring 1.1 x 1.3 x 1.6cm.

Ddx: » Neoplasm - primary vs metastatic » Infection » Connective Tissue Disorder » Vasculitis » Other autoimmune disease » Other inflammatory process

Dxhow: Bx of mass at tongue base revealed squamous cell carcinoma. FNA of lymph node revealed squamous cell carcinoma.

Exam: Notable only for 3x3.5cm firm nodule in level 2 region. Nasopharyngoscope exam was benign.

No MeSH data available.