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On-demand course library with video lectures, expert case reviews, and more
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20% OFFPractice-focused training programs designed to help you gain experience in a specific subspecialty area.
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1 topic
8 topics, 31 min. of video
8 topics, 1 hr. 34 min. of video
8 topics, 48 min. of video
8 topics, 37 min. of video
8 topics, 26 min. of video
8 topics, 17 min. of video
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0:00
So this was an example of a patient that had a mass here
0:05
involving the hard palate. So this was a mass involving the hard palate.
0:09
So remember the hard palate is a component of the oral cavity.
0:15
So this was a tumor that was involving the hard palate.
0:17
And what was actually doing was actually growing superiorly along this
0:22
canal. So if we look at the heart palate here, here's a tumor,
0:26
and this tumor is actually growing superiorly along the incisive canal.
0:31
So this leads us into the conversation about
0:37
tumors that are involving the oral cavity.
0:40
So there are different subsides of the oral cavity.
0:43
So the oral cav cavity sends anteriorly from the lip all the way back
0:48
to the posterior aspect of the heart palate,
0:51
and specifically at about the level of the anterior tonsor pillar.
0:55
So the oral cavity is divided up into six different subsides.
0:59
So here's a tumor involving the right buccal region.
1:02
So this is located between your cheek and your gum.
1:06
This is an example of a tumor that's involving the floor of the mouth.
1:10
This is the normal appearance of the heart palate.
1:13
This is the cancer that we're evaluating this case.
1:16
And I do want to point out this little canal right here.
1:19
That's the incisive canal. Uh, excuse me,
1:22
sorry about this was the alveolar ridge. Apologies for that. This is actually,
1:25
uh, the alveolar ridge. The alveolar ridge is where the two sockets stuck into.
1:29
This is the hard palate. So this is the tumor involving the hard palate, but I,
1:34
but that incisive canal that we're looking for is located right here.
1:38
In the case that we're seeing is that tumors involving in the hard palate.
1:41
And because there's a canal right here, it's growing into it.
1:45
The fourth location of the oral cavity is the oral tongue.
1:48
So you can have tumors that are involving in the oral tongue and later on,
1:52
we'll see an example of this there.
1:55
This area that's behind the last molar is called the retromolar trigone.
1:59
So you can have tumors that are involving the retromolar trigone.
2:02
So these are the six subsites of the oral cavity.
2:06
And these are all examples of tumors that are involving the oral cavity.
2:11
So this is a tumor that's involving the lip.
2:14
This is involving the buccal region.
2:16
This was a squamous cell carcinoma involving the floor of the mouth.
2:20
This was a squamous cell carcinoma involving the alveolar ridge.
2:24
This was a squamous cell carcinoma involving the heart palate that's extending
2:28
in the region of the incisive canal.
2:30
This was a tumor involving the oral tongue.
2:33
And this is an example of a tumor involving the retromolar trigone.
2:39
So these are the six subsites of the oral cavity right here.
2:43
And these are examples of tumors involving each one of those subsites.
Interactive Transcript
0:00
So this was an example of a patient that had a mass here
0:05
involving the hard palate. So this was a mass involving the hard palate.
0:09
So remember the hard palate is a component of the oral cavity.
0:15
So this was a tumor that was involving the hard palate.
0:17
And what was actually doing was actually growing superiorly along this
0:22
canal. So if we look at the heart palate here, here's a tumor,
0:26
and this tumor is actually growing superiorly along the incisive canal.
0:31
So this leads us into the conversation about
0:37
tumors that are involving the oral cavity.
0:40
So there are different subsides of the oral cavity.
0:43
So the oral cav cavity sends anteriorly from the lip all the way back
0:48
to the posterior aspect of the heart palate,
0:51
and specifically at about the level of the anterior tonsor pillar.
0:55
So the oral cavity is divided up into six different subsides.
0:59
So here's a tumor involving the right buccal region.
1:02
So this is located between your cheek and your gum.
1:06
This is an example of a tumor that's involving the floor of the mouth.
1:10
This is the normal appearance of the heart palate.
1:13
This is the cancer that we're evaluating this case.
1:16
And I do want to point out this little canal right here.
1:19
That's the incisive canal. Uh, excuse me,
1:22
sorry about this was the alveolar ridge. Apologies for that. This is actually,
1:25
uh, the alveolar ridge. The alveolar ridge is where the two sockets stuck into.
1:29
This is the hard palate. So this is the tumor involving the hard palate, but I,
1:34
but that incisive canal that we're looking for is located right here.
1:38
In the case that we're seeing is that tumors involving in the hard palate.
1:41
And because there's a canal right here, it's growing into it.
1:45
The fourth location of the oral cavity is the oral tongue.
1:48
So you can have tumors that are involving in the oral tongue and later on,
1:52
we'll see an example of this there.
1:55
This area that's behind the last molar is called the retromolar trigone.
1:59
So you can have tumors that are involving the retromolar trigone.
2:02
So these are the six subsites of the oral cavity.
2:06
And these are all examples of tumors that are involving the oral cavity.
2:11
So this is a tumor that's involving the lip.
2:14
This is involving the buccal region.
2:16
This was a squamous cell carcinoma involving the floor of the mouth.
2:20
This was a squamous cell carcinoma involving the alveolar ridge.
2:24
This was a squamous cell carcinoma involving the heart palate that's extending
2:28
in the region of the incisive canal.
2:30
This was a tumor involving the oral tongue.
2:33
And this is an example of a tumor involving the retromolar trigone.
2:39
So these are the six subsites of the oral cavity right here.
2:43
And these are examples of tumors involving each one of those subsites.
Report
Patient History
Anterior hard palate mass.
Findings
Contrast-enhanced CT was performed from the skull base to the thoracic inlet. The study was performed with a puff cheek technique. This study demonstrates an approximately 1.3 cm mass involving the anterior aspect of the hard palate associated with bone erosion. The mass extends to involve the anterior maxillary alveolar ridge in the expected location of the central and lateral incisors. The sagittal reconstructed images demonstrate superior spread along the incisive canal. The mass involves the anterior third of the palate without evidence of extension into the posterior aspect of the palate. Specifically, the mass does not extend to the region of the alveolar recesses of either maxillary sinus or involve the greater or lesser palatine canal.
No evidence of enlarged cervical lymph nodes is identified based on standard size criteria. Specifically, no evidence of enlarged level 1A or 1B lymph nodes are seen.
No evidence of aggressive lesions is identified involving the nasopharynx, oropharynx, larynx or hypopharynx. There is calcification involving the infrahyoid epiglottis that extends to the petiole.
Visualized portion of the brain is grossly within normal limits. However, dedicated brain imaging is necessary for complete diagnostic evaluation.
Imaging of the lungs is grossly within normal limits. However, dedicated chest CT is necessary for complete diagnostic evaluation.
Conclusions
1. Approximately 1.2 cm mass involving the anterior aspect of the hard palate associated with bone erosion and involvement of the incisive canal (nasopalatine duct). The incisive canal involvement indicates spread along nasal palatine nerve and can be further evaluated with dedicated MR of the hard palate.
Case Discussion
Faculty
David M Yousem, MD, MBA
Professor of Radiology, Vice Chairman and Associate Dean
Johns Hopkins University
Suresh K Mukherji, MD, FACR, MBA
Clinical Professor, University of Illinois & Rutgers University. Faculty, Michigan State University. Director Head & Neck Radiology, ProScan Imaging
Tags
Neuroradiology
Head and Neck
CT
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