Hyun Song MD, Presenter: Nothing to Disclose

So Lyung Jung, Abstract Co-Author: Nothing to Disclose

Sungwon Lee MD, Abstract Co-Author: Nothing to Disclose

Bum Soo Kim, Abstract Co-Author: Nothing to Disclose

Kookjin Ahn MD, PhD, Abstract Co-Author: Nothing to Disclose

Min-Sik Kim, Abstract Co-Author: Nothing to Disclose

Dong-Il Sun, Abstract Co-Author: Nothing to Disclose

Jee Hyun Seok, Abstract Co-Author: Nothing to Disclose

Local extension and lymph node metastasis are important prognostic factors and may change the treatment in tonsilar cancer. MR evaluation of the local extension is difficult because of small size of structures, patient movement, and inhomogeneous magnetic field. The purpose of this study was to evaluate MRI findings suggesting tumor extension into adjacent structures in tonsilar cancer.

We retrospectively reviewed the records of surgery and pathologic results, and findings of MR in 37 patients (33 male, 4 female, age range: 46-79 years, median age: 56 years) with tonsilar cancer. We focused on invasion of soft palate, base of tongue, tongue, floor of mouth, and parapharyngeal space.

Eleven patients were stage I, sixteen were stage II, seven were stage III, and three were stage IV. Soft palate invasion was pathologically confirmed in 11 among 16 patients who showed invasion on MR. Invasion of base of tongue was confirmed in 9 of 15 patients, tongue invasion was 5 of 7, invasion of floor of mouth was 3 of 4, and parapharyngeal invasion was 3 of 8. Major findings of the invasion of soft palate were upper and mid location (11/11), invasion of levator palatini muscle (7/11), midline shift of uvula and soft palate (5/11). Invasion finding of the tongue base was the loss of an air cleft between normal tongue base and tonsilar cancer (9/9). Tongue invasion was seen as irregular marginal enhancement between tongue and mass (4/5) and invasion of extrinsic muscles of the tongue (4/5). Cases with extension into floor of mouth showed the invasion of the mylohyoid muscle, and sublingual and submandibular spaces. Three cases with extension into the parapharyngeal space showed the break of lateral wall of oropharynx and enhancing lesion at the parapharyngeal space.

To be familiar with MR findings of local extension of the tonsilar cancer is very important for precise diagnosis and staging.

 Preoperative T staging of tonsilar cancer with local extension on MR findings is helpful to make a appropriate treatment plan.

Song, H, Jung, S, Lee, S, Kim, B, Ahn, K, Kim, M, Sun, D, Seok, J, What Are the MRI Findings Suggesting the Local Extension of the Tonsillar Cancer?.  Radiological Society of North America 2010 Scientific Assembly and Annual Meeting, November 28 - December 3, 2010 ,Chicago IL. http://archive.rsna.org/2010/9012830.html