Male, 43 years old, with recurrent nasopharyngeal cancer, just completing induction chemotherapy. Restaging exam. Infiltrative enhancing tumor centered on the upper left carotid space is again seen. As before, this lesion infiltrates through the left hypoglossal canal with mild encroachment on the left cerebellar medullary angle, as well as into the left jugular foramen. The size and overall appearance of this lesion have not significantly changed from the prior examination. The lesion measures approximately 30 mm x 24 mm, previously 30 mm x 25 mm. Loss of the flow void at the level of the left sigmoid sinus is seen likely indicating lack of flow or very slow flow.Thickening of the left nasopharyngeal mucosa is again seen with effacement of of the left fossa of Rosenmuller, not significantly changed. No discrete masslike lesion is seen. Marrow replacement and enhancement within the clivus is unchanged.The brain parenchyma shows normal morphology and signal characteristics. No evidence of edema or mass effect is seen. No pathologic parenchymal or leptomeningeal enhancement is identified. No evidence of intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. The ventricles are normal in size and morphology.
1.The left carotid space tumor which infiltrates through the hypoglossal canal and jugular foramen shows no significant interval change in size or morphology.2.Effacement of the left fossa of Rosenmuller and marrow replacement with enhancement in the clivus are stable findings as well.3.No evidence of any brain parenchymal metastatic disease is seen.