Ulcerated left lateral tongue mass measures 2.5 x 2.5 cm with depth of 13 mm. Tumour involves the most superior fibres of hyoglossus is well distended from genioglossus and mylohyoid. There was no evidence of extension onto the floor of mouth on previous CT puffed cheek acquisition.
No mandibular or maxillary bone marrow infiltration. The canal for the inferior alveolar nerve on the left is expanded and contains abnormal enhancing soft tissue, however margins of the canal remains corticated with no surrounding marrow infiltration. Appearance is consistent with a neuroma. This region is distant to the tongue mass, and is not thought to represent perineural involvement by tumour.
No enlarged cervical lymph nodes.
Right mastoid fluid signal.
Conclusion:
Large left lateral tongue ulcerated mass consistent with the history of SCC. The most superior fibres of hyoglossus are involved by the inferior portion of the tumour. A morphologically abnormal lymph nodes or evidence of perineural or osseous spread of disease. The lesion expanding the canal for the left inferior alveolar nerve is consistent with a neuroma.