70 year-old male with known tonsillar cancer. Evaluate CT scan for staging. HEAD CT:There is an approximately 6-mm focus of enhancement in the left frontal lobe in the region of the corona radiata suspicious for metastatic lesion. No vasogenic edema is seen. An MRI may be obtained for further evaluation if clinically indicated. No additional areas of abnormal enhancement.The remaining cerebral hemispheres, cerebellum and brainstem are normal in structure and attenuation. No abnormal extra-axial fluid collections are identified. The ventricles are normal in volume and are midline.No osseous lesions are identified in the calvarium or skull base. The visualized paranasal sinuses and mastoid air cells are normally aerated.NECK CT:There is an approximately 3.9 x 2.6 cm (image) homogeneously enhancing mass involving the right tonsillar pillar reaching the midline as well as extending posteriorly abutting the oropharynx. There is surrounding lymphadenopathy within the right jugulodigastric region the largest of which appears to be a combination of two nodes measuring 12 x 23 mm (image 41/92) at the level of the angle of the right mandible. Additional suspicious nodes are seen at the level of the hyoid on the right. Subcentimeter nonpathologic nodes are seen on the left.The visualized osseous structures are normal.The visualized lung apices are normal. Please refer to the Chest CT performed on the same day for further details.
1. Right tonsillar mass with right neck lymphadenopathy.2. Enhancing focus in the left frontal corona radiata without evidence of vasogenic edema. A metastatic focus as the diagnosis of exclusion. An MRI may be considered if clinically indicated.