R. NICKBRYANMDPATRICIA A.HUDGINSMD
A 50-year-old woman presented with a 3-month history of a left-sided submandibular skin lesion (Figure 1). She did not report any other symptoms related to her head, neck, or dentition. The lesion, which measured 4 mm in diameter, was raised and dark. The findings of examination of the head and neck were otherwise unremarkable.
After failing to respond to a course of oral antibiotics, the lesion was excised. At the time of the procedure, a definite tract was identified passing medial to the body of the mandible and was unable to be followed beyond this point with the patient under local anesthesia. Pathologic examination of the lesion showed a “granulation tract continuous with a sinus tract.” Within 1 month of the procedure, the lesion recurred.
Earnshaw J, Wallwork B. Radiology Quiz Case 2. Arch Otolaryngol Head Neck Surg. 2005;131(12):1117. doi:10.1001/archotol.131.12.1117