T1W SE coronal images before contrast
Recurrence of a tumour of the superior lip and gingiva with clinical signs of involvement of the inferior maxillary nerve
This patient was treated with chemo- and radiotherapy for a SCC of the inferior lip and gingiva, followed by a relapse treated by surgery. A local relapse in the superior lip was treated by limited resection. She presents now with pain in the left V territory and a suspicious burgeoning lesion in the left jugal area. MRI is done with the following sequences : T1w SE axial and coronal, T2w FSE with long TR, T1w SE post Gd with standard and high resolution.
The extension towards the infratemporal fossa is patent and may explain the involvement of the V3. The tumour fills the left buccal vestibula and deeply infiltrates its jugal side. But there is also extension towards the maxillary side with effraction of the maxillary sinus outer wall, best depicted by the high resolution slices. More anteriorly, inflammatory changes develop in the maxillary sinus. Biopsy confirmed the relapse. A new chemotherapy was given, but did not success and the patient died 8 months later.
Differential Diagnosis List
Recurrence of a squamous cell carcinoma of the lip with perineural spread