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A re‐evaluation of imaging criteria to assess aggressive masticator space tumors
Author(s) -
Som Peter M.,
Curtin Hugh D.,
Silvers Adam R.
Publication year - 1997
Publication title -
head and neck
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.012
H-Index - 127
eISSN - 1097-0347
pISSN - 1043-3074
DOI - 10.1002/(sici)1097-0347(199707)19:4<335::aid-hed12>3.0.co;2-8
Subject(s) - malignancy , medicine , fascia , magnetic resonance imaging , radiology , bone erosion , pathology , rheumatoid arthritis
Purpose To evaluate the correlation between the gross imaging evidence of an aggressive masticator space (MS) tumor and the presence of such a MS malignancy. Materials and Methods Thirty patients were identified retrospectively who had a malignancy that either arose in or metastasized to the MS, had pathologic verification of the diagnosis, and had magnetic resonance (MR) and/or computed tomographic (CT) images. Specifically evaluated was the presence or absence of gross imaging evidence of mandibular erosion and the integrity of the medial MS fascia as evaluated by a smooth margin between this fascia and the parapharyngeal space fat. Results Of the 30 tumors, 28 were high‐grade malignancies and 2 were histiocytoses. Of these, 5 had mandibular erosion and violation of the MS fascia, 19 had bone erosion with an intact fascia, 4 had neither bone erosion nor fascial violation (3 of these patients were under the age of 20 years), and 2 had fascial violation with no bone erosion. Conclusions In 76.7% of patients with a malignancy arising in the MS, on imaging the medial MS fascia was grossly intact. There were 4 patients with MS malignancy and neither violation of the medial MS fascia nor mandibular bone erosion. Thus, these imaging findings may not be good criteria to evaluate the presence of a high‐grade MS malignancy, especially if the patient is under the age of 20 years, in which age group MS sarcomas are more likely to arise. © 1997 John Wiley & Sons, Inc. Head Neck 19 : 335–341, 1997.