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Clinical Problem Solving
October 2013

Swelling of Submandibular Region

Author Affiliations
  • 1Tulane School of Medicine, New Orleans, Louisiana
JAMA Otolaryngol Head Neck Surg. 2013;139(10):1073-1074. doi:10.1001/jamaoto.2013.4410

A man in his 30s with no significant medical history presented with a subtle soft swelling of his right submandibular region for the past 8 months. In the previous 24 hours it had rapidly expanded with painful neck swelling, dysphagia, and mild shortness of breath with supine and intermittent fever. Physical examination revealed a soft and easily compressible neck mass with overlying skin erythema with no obvious involvement of the floor of the mouth. Flexible fiberoptic laryngoscopy revealed no suspicious lesions and symmetric vocal cord movement. Contrast-enhanced computed tomographic (CT) imaging of the neck revealed a 6-cm well-circumscribed mass with septations within the right sublingual space herniating through the mylohyoid muscle into the right submandibular space as shown in the Figure (A and B, axial; C, sagittal reformatted; and D, coronal reformatted). The patient was taken to the operating room for transcervical excision of the lesion.

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