Male, 15 years old, with history of recurrent juvenile angiofibroma, and two episodes of epistaxis since prior imaging, granulation tissue evident on the posterior septum. Assess and compare to prior imaging. Evidence of prior sinonasal surgery is seen for partial resection of a juvenile angiofibroma. Residual infiltrative enhancing tissue remains involving the left sphenoid bone, the pterygopalatine fossa, the left cavernous sinus, sella and clivus, and to a lesser degree the left masticator space. On comparison with the prior examination, the size and extent of this residual enhancing tissue has not convincingly changed. There is a greater degree of what likely represents sinus mucosal thickening along the residual walls of the left maxillary sinus. Mucosal thickening within the left ethmoidectomy bed has not significantly changed. No definite evidence of any new sinonasal lesion is seen.
Evidence of extensive prior sinonasal surgery is seen for partial resection of the juvenile angiofibroma. Enhancing tissue centered on the left sphenoid bone with extension to the surrounding spaces is redemonstrated which most likely represents tumor. Since the prior examination, no definite increase in tumor size is seen, and no new lesions are identified.