Male, 62 years old, history of nasopharyngeal carcinoma status post CRT with cranial nerve 12 palsy. Concern for recurrence. Brain:Two or three scattered small foci of nonspecific T2 hyperintensity are evident within the cerebral hemispheres.No restricted diffusion is seen. No evidence of parenchymal edema or mass effect is detected. On postcontrast images, no pathologic parenchymal or extra-axial enhancement is observed.No significant intracranial hemorrhage or any abnormal extra axial fluid collection is seen. Ventricular size and morphology are within normal limits.Neck:Imaging of the neck is somewhat degraded by motion artifact. Within this limitation, the following observations are made.Mild pooling secretions are evident in the nasopharynx, but no mucosal lesion is seen.Mild atrophy of the intrinsic tongue and floor of mouth muscles is suspected on the left. No tongue or tongue base mass is demonstrated. No clear evidence of any focal lesion is seen along the expected course of the hypoglossal nerves.Volume loss in the left neck is likely related to prior therapy, as is infiltration of the fascial planes and scarring, particularly along the left carotid space.No pathologic adenopathy is detected by size criteria. No mass lesion is seen. The visualized salivary glands and thyroid are free of focal lesions.Vertebral body marrow signal characteristics are unremarkable. Mild cervical spondylosis is evident without significant spinal canal stenosis. The visualized spinal cord is unremarkable.
1.No evidence of intracranial metastases.2.Mild atrophy of the left tongue is suspected.3.No evidence of tumor recurrence, pathologic adenopathy, or any other specific findings are seen in the neck to account for the patient's symptoms.