Imaging evaluation of the benign and malignant lesions of the floor of the mouth: Pictorial review.

The floor of the mouth is an important anatomical region of the oral cavity where primary benign and malignant disease processes can originate or secondary pathologies can extend into adjacent spaces. Knowledge of the anatomy is crucial for accurate localisation of pathology and understanding the spread of disease. The sublingual space is the dominant component of the floor of the mouth, bounded inferiorly by the mylohyoid muscle that separates it from the submandibular space. Imaging is immensely important to characterise and map the extent of disease, considering the fact that the bulk of the disease may be submucosal and not visible on clinical inspection. Contribution: The floor of the mouth is a complex anatomical region for radiological evaluation. The purpose of this pictorial review is to present an understanding of the relevant anatomy and to demonstrate the role and appropriate application of different imaging modalities. This article highlights the imaging spectrum of a wide range of various benign conditions including normal variants and a variety of malignant lesions at different tumour stages, with an aim to establish the correct diagnosis, avoid misinterpretation and help in treatment planning.

Lumbar Facet Joint Fluid: A Reliable Sign of Lumbar Instability.

Lumbar degenerative spondylolisthesis (LDS) is a prevalent condition among the elderly population. Magnetic resonance imaging (MRI) is often the first investigative modality if indicated clinically. However, the standard supine position used during an MRI may fail to detect dynamic instability. In such cases, the presence of facet joint fluid is a reliable sign, and further investigation, such as stress radiographs, should be conducted to confirm dynamic instability. Here, we present a typical case demonstrating the importance of this finding. A patient presented with neurological claudication, and an MRI was initially unremarkable except for the presence of lumbar facet joint fluid. This finding prompted us to conduct stress radiographs, which eventually confirmed dynamic instability.

Nontraumatic intradiploic arachnoid cyst of the sphenoid bone.

The intradiploic arachnoid cysts are rare radiological entities which are generally post-traumatic in nature and occur mostly in occipital region. We present a rare case of non-traumatic, asymptomatic intradiploic cyst of the greater wing of sphenoid in an elderly patient. The CT and MR imaging confirmed an intraosseous multiloculated cystic lesion which showed communication with the cerebrospinal fluid in anterior temporal fossa, through the small bony defects.

MRI of ectopic posterior pituitary gland with dysgenesis of pituitary stalk in a patient with hypogonadotropic hypogonadism.

The ectopic posterior pituitary is a rare condition which is characterized by the ectopic location of posterior lobe of pituitary, pituitary stalk abnormalities, and associated clinical manifestations of anterior lobe related growth hormone dysfunction or less commonly multiple anterior pituitary dysfunctions. We present a rare case of posterior ectopic pituitary and pituitary stalk hypoplasia with isolated hypogonadotropic hypogonadism in a 36-year-old female patient.

Large Vallecular Masses; Differential Diagnosis and Imaging Features.

Large vallecular masses are an uncommon disease entity which includes a wide spectrum of rare pathologies. These masses may present as purely vallecular in location or appear as an extension from adjacent anatomical sites like tongue base including lingual tonsils, epiglottis, palatine tonsils, epiglottis, and the remainder of supraglottis. Literature review reveals very rare conditions presenting as vallecular mass lesions. The imaging features are generally diagnostic for characterization. However, these masses can exhibit indeterminate appearance at imaging. We present a series of five cases which includes two rare presentations: a case of low-grade cribriform adenocarcinoma of the base of tongue and a vallecular lipoma. The other three cases presented for differential diagnosis including benign vallecular cysts and two cases to show that malignant masses arising from neighboring anatomical sites such as tongue base or supraglottic larynx can exhibit significant vallecular component.

Evaluation of adnexal masses by ultrasound and fine needle aspiration cytology.

Forty Eight cases of adnexal masses were subjected to ultrasound and FNAC. In this study, FNAC could differentiate benign and malignant adnexal masses in 98% of cases where as ultrasound was successful in 85% of cases. FNAC is a safe simple, rapid & reliable investigation. The complex adnexal masses present a diagnostic challenge with particular reference to the findings predictive of malignancy.