Head and Neck Imaging

Sublingual space, pathology

commonly related to Wharton's duct, pathology , mainly sialolithiasis .
Squamous cell carcinoma, head and neck arising in the anterior floor of the mouth or gingivobuccal sulcus commonly spreads into the sublingual space; such extension can be readily recognized on CT or MRI studies as loss of the normal symmetrical appearance of the sublingual spaces.
Pathology arising from the sublingual gland is rare; however, sublingual gland neoplasms are predominantly malignant and thus important to recognize. Most patients present with a submucosal mass under the tongue causing discomfort (Fig. 1). Adenoid cystic carcinoma and mucoepidermoid carcinoma are the types most frequently encountered.

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Fig. 01a

Axial (a) and coronal (b) gadolinium-enhanced T1-weighted spin-echo images of the floor of the mouth and tongue. An enhancing soft tissue mass is seen in the right sublingual space, growing through the mylohyoid muscle (white arrow); superomedial extension into the tongue with invasion of the genioglossal muscle (white arrowhead); posterior extension between the mylohyoid and hyoglossal muscle (black arrowheads). Adenoid cystic carcinoma, arising from sublingual gland. Normal sublingual gland is seen on opposite side (black arrow).
Sublingual space, pathology, Fig. 01a (a)
Sublingual space, pathology, Fig. 01b (b)