Fig. 1

Patient status. A Oral findings at first examination: a pedunculated tumour (approximately 65 × 45 mm) is present in the left lower gingiva. The base is localised in the alveolar region, and the surface is granulomatous, elastic-hard with partial ulcerations, and haemorrhagic. The tongue is displaced rightward by the tumour (arrow). B Panoramic radiography revealed compressive bone resorption in the region corresponding to the tumour (arrow). C MRI images: (a) Contrast T1-Gd-MRI revealed significant contrast throughout the tumour, more pronounced along the margin; (b) T2-STIR-MRI revealed a high intensity at the margin and moderate intensity in the inner region. D Imaging of the submandibular lymph node: (a) in the contrast-enhanced CT image, contrast-enhanced swollen lymph nodes (arrows) are present in the bilateral submandibular regions. Both the right (b) and left (c) submandibular lymph nodes are soft, with smooth margins on cervical echo. The hilum of the lymph node is clear, but an increase in blood flow is noted in the hilum region. T1-Gd-MRI: T1-weighted gadolinium-enhanced magnetic resonance imaging, T2-STIR: T2-weighted short inversion recovery