case_images: PMC11790334_01
case_images: Magnetic resonance imaging. The T2-weighted image shows a slightly high-signal area (dotted line) at the apex of the tongue.
case_images: cureus-0017-00000076917-i01.jpg
case_images: PMC11790334_01_cureus-0017-00000076917-i01.jpg
case_images: FIG1
case_images: Surgical photos. (A) A mass of approximately 10 mm length and diameter was found at the apex of the tongue. The resection line indicated by the arrowhead is a safety margin of approximately 3 mm from the mass, and the resection line indicated by the arrow is a safety margin of approximately 10 mm from the mass. (B) After resection with a safety margin of 3 mm. (C) After additional resection with a safety margin of 10 mm.
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case_images: PMC11790334_01_cureus-0017-00000076917-i02.jpg
case_images: FIG2
case_images: Since the preoperative examination did not show a malignant tumor, the safety margin was set as 3 mm and 10 mm from the tumor (Figure 2A). Tumor resection was performed initially with a safety margin of 3 mm (Figure 2B). After obtaining the intraoperative frozen section diagnosis of suspected SDC, an additional 7 mm was resected, and the defect was sutured (Figures 2C, 3A, 3B).
case_images: Resection specimen. (A) Resection specimen with a safety margin of 3 mm. (B) Additional resection specimen with a safety margin of 10 mm.
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case_images: PMC11790334_01_cureus-0017-00000076917-i03.jpg
case_images: FIG3
case_images: After obtaining the intraoperative frozen section diagnosis of suspected SDC, an additional 7 mm was resected, and the defect was sutured (Figures 2C, 3A, 3B).
case_images: Histopathological findings. Histological study of the excised lesion revealed the tumor invading toward the deep portion of the lingual muscle (A). Large atypical cells with eosinophilic cytoplasm form large and small foci, some of which show central necrosis known as comedo necrosis (A, B). Minor salivary glands were found beside the tumor nest (B). In higher magnification, there was comedo necrosis within the tumor nest, the roman-bridge architecture of the tumor nest, and fibrosis in the stroma (C). There is a lack the basal cell/myoepithelial cell suggesting that these tumor nests are invasive components. There was nuclear atypia in higher magnification (D). Hematoxylin and eosin stain (Magnification: A x50, B x100, C x200, D x400).
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case_images: PMC11790334_01_cureus-0017-00000076917-i04.jpg
case_images: FIG4
case_images: Moreover, there were no nodules or nodular scars suspected of pleomorphic adenoma and no extensive intraductal extension (Figures 4A-4D).
case_images: FDG-PET/CT scans performed after the postoperative definitive diagnosis showing no cervical lymph node or distant metastases. FDG - fluorodeoxyglucose
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case_images: PMC11790334_01_cureus-0017-00000076917-i05.jpg
case_images: FIG5
case_images: No cervical lymph node or distant metastases were found on and fluorodeoxyglucose (FDG)-PET/CT scans performed after the postoperative definitive diagnosis (Figure 5).