Denervation hypertrophy may mimic local tumor spread on magnetic resonance imaging.
We report a patient with an extensive paranasal sinus carcinoma. One year after tumor resection, magnetic resonance imaging (MRI) showed swelling of the ipsilateral masticatory muscles with signal increase on T2-weighted images and gadolinium-DTPA uptake, suggestive of local tumor infiltration. However, electromyography, biopsy, and follow-up MRI confirmed denervation pseudohypertrophy of the muscles innervated by the mandibular nerve and excluded tumor recurrence. Muscle denervation and pseudohypertrophy should be considered in the differential diagnosis of appropriate patients with suspected tumor recurrence.
Department of Neurology, University of Würzburg, Josef-Schneider-Strasse 11, 97080 Würzburg, Germany. wessig_c@klinik.uni-wuerzburg.de
Carsten
C
Wessig
Werner
W
Kenn
Martin
M
Koltzenburg
Martin
M
Bendszus
D000328:Adult; D002277:Carcinoma / Q000601:surgery; D004576:Electromyography / Q000379:methods; D007839:Functional Laterality / Q000502:physiology; D006801:Humans; D006984:Hypertrophy; D008279:Magnetic Resonance Imaging; D008297:Male; D009121:Muscle Denervation; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis*; D010255:Paranasal Sinus Neoplasms / Q000601:surgery