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DISTANT
METASTASIS - The Hypoglossal Nerve
Now viewing: Case
13
Case 13 -
a. Adenoid cystic carcinoma of tongue, post-operative status without evidence
of recurrence
b. Exensive perineural metastasis to hypoglossal, spinal accessory, vagus and
glossopharygeal nerves
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| A 52-year-old
male had right partial glossectomy and bilateral neck dissection for a
tumor mass of the right side of the tongue with pre and post radiation
therapy 6 years ago. The pathology revealed adenoid cystic carcinoma
of the tongue with extensive invasion to the cervical lymph node and
at the right internal jugular vein at the base of the skull. Patient
presented with complaints of dysphia involving both liquids and
solids. Examination revealed post-operative status of the right tongue
without evidence of recurrence. There was paralysis of the right true
cord and right soft palate. Admission MRI of the head and neck
revealed enhancing soft tissue masses in the region of the right
hypoglossal canal and right jugular foramen. The findings are
consistent with perineural metastasis to right hypoglossal cranial
nerve and IX, X & XI cranial nerves. |
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| Sagittal
T1-weighted MR image (TR 550/TE 16): (6 Years after surgery):
post-operative status of the anterior tongue without evidence of
recurrence (arrow). |
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Axial
post-contrast T1-weighted MR image (TR 500/TE 20) at the level of
the clivus 6 years after surgery: soft tissue tumor mass with
intermediate signal intensity within the right hypoglossal canal
and destruction of the bony boundary of the canal(1). Areas of
soft tissue densities with intermediate signal intensities are
seen in the area of the right jugular foramen consistent with
involvement of IX, X & XI cranial nerves (2). There is
extension of the lesion into the cerebello-pontine angle cistern. |
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The Levit Radiologic - Pathologic Institute
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Last updated;
February 2002 - contact Webmaster
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