84-year-old male with a history of hnc and CRT, compare to previous measurements.Additional history from EMR: Adenoid cystic carcinoma of the right parotid gland (T4aN0), underwent right total parotidectomy and a right selective neck dissection with a rotational skin flap closure on 2/16/12. Redemonstrated are post-operative changes of a previous right parotidectomy without evidence of recurrence. A left parotid 7 x 6 mm T2 hyperintense nonenhancing cystic lesion is again seen which is nonspecific but remains unchanged in size. Chronic denervation changes are again seen in the left masticator space. There is stable nonspecific enhancement of the left petrous apex corresponding to the location of a previous dural based enhancing mass.The ventricles and sulci are prominent but stable, consistent with moderate age-related volume loss. The basal cisterns remain patent. There is no midline shift or mass effect. There are stable scattered nonspecific punctate foci of T2/FLAIR hyperintensity which could relate to mild chronic small vessel ischemic changes. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. There is persistent fluid signal again seen within the right mastoid air cells.
1.Stable MRI of the brain without evidence of new intracranial metastatic disease.2.Stable postoperative changes in the right parotidectomy bed without recurrence 3.Unchanged appearance of the nonspecific subcentimeter cystic lesion in the left parotid gland centrally.4.Persistent nonspecific enhancement along the left petrous apex, adjacent to area of previous dural based mass may reflect post-treatment changes.