PMC3169347_01
(a) Extraoral profile view showing left submandibular swelling. (b) Extraoral view showing submandibular swelling. (c) Intraoral view showing absence of swelling in floor of the mouth.
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On examination, a diffuse, soft, fluctuant, nontender swelling, about 7 x 5 cm in size, was present in left submandibular region (Figure 1(a)). A scar was visible near left angle of mandible, which was the site of previous surgical intervention (Figure 1(b)). Intraorally, no swelling was evident in sublingual areas bilaterally (Figure 1(c)).
(a) Ultrasonogram showing anechoic fluid collection in left submandibular region. (b) Lateral oblique projection of submandibular region with contrast media injected in sublingual space. (c) Coronal T-1 weighed MR image showing hypointense area of fluid collection above and below the mylohyoid muscle. (d) T-2 weighed axial MRI section showing the extensions of the fluid collection.
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Ultrasonography of the swelling showed an anechoic, bilobed fluid collection in left submandibular region with a superficial and deep component (Figure 2(a)). 1.0 ml of a water-based iodine contrast media was injected in left sublingual region and a lateral oblique projection of left submandibular region was made to view the extensions (Figure 2(b)). T-2 weighed MRI images, showed hyperintense fluid filled cavity in left sublingual space, extending to left submandibular space along the posterior edge of mylohyoid muscle (Figures 2(c) and 2(d)).
Histopathological picture of the excised lesion showing mucin collection in the lumen lined by connective tissue with inflammatory cells.
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The excision of the lesion was done via cervical approach under general anaesthesia and the tissue was subjected to histopathological evaluation (Figure 3).