 The left frontal sinus is completely opacified with a peripheral rind of T1 isointensity to brain which enhances, with central T1 hyperintensity, likely representing obstructive inspissated secretions.There is a T1 isointense to brain and T2 hyperintense lesion in the left frontoethmoidal recess and the left anterior ethmoid, which is diffusely enhancing. There is dehiscence of the lateral wall of the frontoethmoidal recess at this level and there is an extraconal enhancing component along the medial aspect of the left orbit. There is mass effect on the extraconal left orbit, although the muscles remain discrete. There is also dehiscence of the left ethmoid roof. There is adjacent dural thickening of the left inferior frontal lobe.There is mucosal thickening of both maxillary sinuses, left more than the right.There are extensive paranasal sinus post-operative changes, including bilateral antrostomies which are patent.
1. There is a stable enhancing mass in the left frontoethmoidal recess, extending into the left anterior ethmoid sinus. Extra conal left orbital component with dehiscence of the lateral wall of the frontoethmoidal recess and left ethmoid roof. This mass is likely to represent recurrence of squamous cell carcinoma. MRI of the brain is recommended to assess for brain parenchymal involvement.2. Probable mucosal thickening of the left frontal sinus with associated obstructive inspissated secretions.3. Mucosal thickening of the maxillary sinuses bilaterally, left greater than right.