ke/sb/nl/rg.
Name of the Patient : Abc Xyzed Qurlmn / M / 34 yrs.
Referred by : Dr. Abc Xyzlwani.
Examination : M.R.I. of the Face.
CLINICAL PROFILE :
H/O swelling over the right cheek in January 0000 for which patient was operated and lesion excised. HP s/o hemangioma.
Recurrence of symptoms in 0000. Excised again.
Now again recurred since 2 years.
EXAMINATION :
M.R.I of the face was performed using the following parameters :
7 mm thick T1 Weighted and T2 Weighted (with fat saturation)
sagittal images.
8 mm thick T1 Weighted and T2 Weighted axial images.
7 mm thick T1 Weighted and T2 Weighted (with fat saturation)
coronal images.
OBSERVATION :
There is a large, ill-defined, lobulated mass lesion having its epicentre in the right mandibular region. Anteriorly this lesion is seen to extend upto the mentum and the submental region region. Posteriorly there is involvement of the lingual muscles. Laterally there is extension in the right infratemporal region. Extension is also noted lateral to the right zygomatic arch and in the muscles and soft tissues around the right cheek. Involvement of the right pterygoid fossa and its contents encasing the mandible and the styloid process is seen. There appears to be destruction of the body of the mandible on the right side and in the midline. Superiorly there is extension in the subgaleal region in the right fronto-temporal region with involvement of the superior eyelid on the right side. Right sided enopthalmous is noted. Posterior extension is seen in the prevertebral region and the nasopharynx. There is suggestion of
..2/.
thinning/erosion of the right temporal bone with a suspicious extradural component in the right temporal region (se/im:107/5). There is extension into the upper lip. This lesion is slightly hyperintense to muscle on the T1 Weighted images and turns heterogeneously hyperintense on the T2 Weighted images. Multiple punctate and curvilinear signal void areas are seen on all the pulse sequences and would represent phleboliths/blood vessels.
The right carotid sheath is noted along the posterior margin of the lesion. Probable destruction of the maxilla on the right is noted. The tongue is deviated to the left. The right sided submandibular salivary gland is not well-identified.
IMPRESSION :
In a known C/O soft tissue hemangioma, the MRI features are suggestive of a lobulated mass lesion involving the right side of the face with extensions as described. Bone erosion/destruction is also as described.