PMC10453962_01
Neck CT showing a low-attenuation mass in the tongue with internal calcifications (thick arrow in A). The contrast-enhanced images demonstrate septa-like structures within the cystic mass (thin arrows in C, E, and F). The bilateral sublingual glands are displaced inferiorly by the mass (arrowhead in D).
jbsr-107-1-3156-g1.jpg
PMC10453962_01_jbsr-107-1-3156-g1.jpg
F1
CT images showed a low-attenuation mass with multifocal internal calcifications, and septa-like structures were observed within the mass (Figure 1).
Neck MRI showing a cystic mass that is hyperintense on T2WI (A) and isointense on T1WI (B) with internal calcifications observed as punctate hypointensities on T2WI (arrowhead in A). The contrast-enhanced T1WIs reveal thin enhancements at the internal septations and peripheral wall of the mass (arrows in C, E, and F). The fat-suppressed T2WI show no evidence of fat components in the mass (D). The diffusion-weighted and apparent diffusion coefficient images show no significant diffusion restriction (G and H).
jbsr-107-1-3156-g2.jpg
PMC10453962_01_jbsr-107-1-3156-g2.jpg
F2
T2-weighted imaging (T2WI) and isointense on T1-weighted imaging (T1WI) with thin enhancing internal multiseptations (Figure 2). There was no evidence of pathological lymph node in the neck.
Histopathological examination reveals abundant mucin pools lined with goblet cells, suggestive of intestinal-type epithelium. Floating epithelial cells with areas of nuclear dysplasia and transition to adenocarcinomas are observed within the mucin on hematoxylin-eosin staining (arrow in B). The tumor cells show strong positive staining for CK20 (C) and negative staining for CK7 (D), AR (E), and P63 (F): magnification x100 (A) and x200 (B-F).
jbsr-107-1-3156-g3.jpg
PMC10453962_01_jbsr-107-1-3156-g3.jpg
F3
After histopathological analysis of the excised mass, the final diagnosis was mucinous adenocarcinoma (Figure 3), and tumor involvement at the resection margin was positive.
The positron emission tomography/CT images show no evidence of increased uptake in any location, except at the resection margin of the tongue.
jbsr-107-1-3156-g4.jpg
PMC10453962_01_jbsr-107-1-3156-g4.jpg
F4
The patient underwent positron emission tomography/CT scan to exclude the possibility of a metastatic lesion from a primary intestinal malignancy, and there was no evidence of a metabolically active lesion in any location other than the resection margin of the tongue (Figure 4).