22 year-old with a 3 year history of fluctuating submandibular region lump
Axial T1 noncontrast
Axial STIR
Coronal T1 fat sat post Gad
Lateral and frontal fluoroscopic images pre and post sclerotherapy procedure with Sotradecol and then ethanol.
Findings:
Loculated right
submental mass which resides mostly in the submandibular space
displacing the mylohyoid muscle and adjacent anterior belly of the
digastric muscle that extends to the floor of mouth, as well as the
posterior margin of sublingual gland
DDX:
lymphangioma, ranula, cystic tumor, epidermoid
Diagnosis:
Lymphangioma
Discussion:
Lymphangiomas
are uncommon, hamartomatous, congenital malformations of the lymphatic
system that involve the skin and subcutaneous tissues. Lymphatic
malformations can be categorized as superficial cutaneous lymphangioma,
cavernous lymphangioma, cystic hygroma, or diffuse systemic
lymphangioma. The most common sites are the head and the neck, followed
by the proximal extremities, the buttocks, and the trunk.
Pathogenesis in uncertain but may arise from a primitive lymph
sac that fails to connect with the rest of the lymphatic system during
its embryonic development. It is rare for lymphangiomas to make their
initial presentation during adulthood. Approximately 60% of
lymphangiomas are present at birth, and up to 90% are detectable by 2
years of age
Submitted by Asako Miyakoshi, MD, UW Neuroradiology
Return to UW Neuroradiology Teaching Files