Glottic Squamous Cell Carcinoma Invading the Carotid Space
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This was a patient who had discomfort in the left side
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of the floor of the mouth and was being evaluated
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for a potential cyst in the floor of the mouth.
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When we did the MRI scan,
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we were a little bit confused because we saw this big
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black thing that was associated with
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the submandibular gland.
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Now, this is a big black thing in the gland
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rather than the duct.
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If we look at the T2-weighted scan,
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we see that it is entirely within the gland.
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But within the gland,
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you see focal ductal dilatation of the
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glandular ductal system.
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So this was not a Wharton's duct,
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a submandibular ductal calcification.
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This was a glandular calcification that
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was obstructing the ductal system,
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compared these ducts to the normal caliber
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of the right-sided duct.
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Not only that, but on the right side,
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you see a nice example of Wharton's duct
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crossing into the sublingual space.
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Here we have the mass that is still
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contained within the submandibular tissue.
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On post-gadolinium-enhanced scan, we notice
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that there is this non-enhancing
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lesion within the gland.
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The gland itself is a little bit enlarged
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compared to the right side.
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Nothing going on in the floor of the mouth.
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This was a big rock.
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This was a big stone in the gland.
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And there is a difference between the stones in
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the gland versus the stones in the ducts.
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The stones in the ducts tend to be obstructive and lead
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to more symptoms than those that are
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just located in the gland itself.
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And.
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
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