A 40-year-old woman complained of a painless mass in the left side of the floor of the mouth. A 2×2cm round, smooth, nontender mass was palpable on the left side of the floor of the mouth; it was fixed to the symphysis of the mandible. No cervical lymph nodes were palpable. T2-weighted MRI scan of the tumor showed smooth margins and a heterogeneous signal. A contrast-enhanced CT scan showed a slightly enhanced mass lesion. Radionuclide scanning with 67Ga showed a hot tumor. Radiography revealed a malignant tumor originating in a minor salivary gland or a sublingual gland. Microscopic examination of the tumor showed adenocarcinoma.
Radical neck dissection was combined with resection of the left side of the floor of the mouth and of the internal margin of the mandible. The surgical defect was reconstructed with a rectus abdominis musculocutaneous flap.
Postoperative evaluation of mastication and articulation was good. The patient had no evidence of recurrence one year after surgery.
