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Thoracic radiographs showed an axial gastro\u2010esophageal hiatal hernia, diaphragmatic thickening, and asymmetry. Magnetic resonance imaging of the head showed a severely enlarged tongue, symmetric increase in size of the geniohyoid and mylohyoid muscles, and diffuse masticatory hypomyotrophy. Whole\u2010body CT ruled out other musculoskeletal abnormalities and further characterized the radiographic and MRI findings. 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