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Wk 6, Case 1 - Review

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Report

Patient History
Anterior hard palate mass.

Findings
Contrast-enhanced CT was performed from the skull base to the thoracic inlet. The study was performed with a puff cheek technique. This study demonstrates an approximately 1.3 cm mass involving the anterior aspect of the hard palate associated with bone erosion. The mass extends to involve the anterior maxillary alveolar ridge in the expected location of the central and lateral incisors. The sagittal reconstructed images demonstrate superior spread along the incisive canal. The mass involves the anterior third of the palate without evidence of extension into the posterior aspect of the palate. Specifically, the mass does not extend to the region of the alveolar recesses of either maxillary sinus or involve the greater or lesser palatine canal.

No evidence of enlarged cervical lymph nodes is identified based on standard size criteria. Specifically, no evidence of enlarged level 1A or 1B lymph nodes are seen.

No evidence of aggressive lesions is identified involving the nasopharynx, oropharynx, larynx or hypopharynx. There is calcification involving the infrahyoid epiglottis that extends to the petiole.

Visualized portion of the brain is grossly within normal limits. However, dedicated brain imaging is necessary for complete diagnostic evaluation.

Imaging of the lungs is grossly within normal limits. However, dedicated chest CT is necessary for complete diagnostic evaluation.

Conclusions
1. Approximately 1.2 cm mass involving the anterior aspect of the hard palate associated with bone erosion and involvement of the incisive canal (nasopalatine duct). The incisive canal involvement indicates spread along nasal palatine nerve and can be further evaluated with dedicated MR of the hard palate.

Case Discussion

Faculty

David M Yousem, MD, MBA

Professor of Radiology, Vice Chairman and Associate Dean

Johns Hopkins University

Suresh K Mukherji, MD, FACR, MBA

Clinical Professor, University of Illinois & Rutgers University. Faculty, Michigan State University. Director Head & Neck Radiology, ProScan Imaging

Tags

Neuroradiology

Head and Neck

CT

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