CT and MRI Key Features of Benign Tumors and Tumor-like Lesions of the Tongue: A Pictorial Review

Benign neoplasms and tumor-like lesions of the tongue are relatively rare entities, encompassing a heterogeneous spectrum of morphological alterations. The recent literature focusing on benign tumors and tumor-like lesions of the tongue is relatively limited, which may lead to a gap in understanding their specific imaging characteristics. Most benign tongue tumors usually appear as submucosal bulges located in the deep portion of the tongue. Both computed tomography (CT) and magnetic resonance imaging (MRI) are essential for the comprehensive diagnostic evaluation of these entities. Cross-sectional imaging plays a pivotal role in narrowing the differential diagnosis and, in selected cases, may suggest a specific histopathological entity. The benign tumors and tumor-like lesions included in this review comprise schwannoma, lipoma, angiomyolipoma, hemangioma, vascular malformations, dermoid cysts, and thyroglossal duct remnants (including cystic formations and ectopic thyroid tissue). Additionally, certain non-neoplastic conditions-such as lingual abscesses, infectious mononucleosis complicated by lingual tonsillitis, and fatty atrophy of the tongue-can mimic neoplastic processes and present as mass-like lesions; these have also been addressed in this pictorial essay. The purpose of this work is to illustrate the key CT and MRI features of the aforementioned benign lingual lesions, with the aim of improving diagnostic confidence and accuracy.