Péporté Anne R J, Moser Andreas A, Wagner Franca
Radiology, Kantonsspital Frauenfeld, Frauenfeld, 8500, Switzerland.
Otorhinolaryngology, ORL Appenzell, Appenzell, 9050, Switzerland.
Eur Arch Otorhinolaryngol. 2025 Apr;282(4):2173-2178. doi: 10.1007/s00405-024-09137-3. Epub 2024 Dec 19.
To describe a rare case of heterotopic submandibular gland (SMG) tissue herniating through the mylohyoid boutonnière into the anterior submandibular space, diagnosed using imaging, and to provide insights into its clinical implications.
A 59-year-old male with a history of smoking and type 2 diabetes presented with new-onset hoarseness. Imaging, including contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI), was performed. The lesion's imaging characteristics, location, and tissue composition on CT and MRI were analyzed, and differential diagnoses were considered.
CT and MRI revealed a well-defined soft tissue lesion in the right anterior submandibular space, exhibiting features consistent with ectopic SMG tissue. On MRI, the lesion was iso- to slightly hyperintense compared to surrounding muscle tissue and showed ductal structures leading to the sublingual space, with a discontinuity in the mylohyoid muscle. No malignancy or other pathologies were identified, and the patient's hoarseness improved with treatment for dyspepsia.
This case highlights the diagnostic value of imaging in identifying rare anatomical anomalies like heterotopic SMG with herniation through the mylohyoid boutonnière. Accurate diagnosis can prevent unnecessary procedures and guide appropriate management.
描述一例罕见的异位下颌下腺（SMG）组织通过下颌舌骨肌纽扣样疝入下颌下前间隙的病例，通过影像学进行诊断，并探讨其临床意义。
一名有吸烟史和2型糖尿病史的59岁男性出现新发声音嘶哑。进行了包括增强计算机断层扫描（CT）和磁共振成像（MRI）在内的影像学检查。分析了病变在CT和MRI上的影像学特征、位置和组织成分，并考虑了鉴别诊断。
CT和MRI显示右侧下颌下前间隙有一个边界清晰的软组织病变，表现出与异位SMG组织一致的特征。在MRI上，该病变与周围肌肉组织相比呈等信号至稍高信号，可见导管结构通向舌下间隙，下颌舌骨肌有连续性中断。未发现恶性肿瘤或其他病变，患者的声音嘶哑经消化不良治疗后有所改善。
本病例突出了影像学在识别罕见解剖异常（如通过下颌舌骨肌纽扣样疝出的异位SMG）方面的诊断价值。准确的诊断可以避免不必要的手术，并指导适当的治疗。
