Nasopharyngeal carcinoma, status post treatment. Neck: There has been marked interval decrease in size of the left nasopharyngeal mass, which now measures up to approximately 7 mm, previously approximately 40 mm. The remaining tumor also appears necrotic. There is no evidence of intracranial extension or skull base erosion. There are secretions in the right lateral nasopharyngeal recess. A cystic or necrotic right level 2B lymph node measures 5 x 10 mm in axial cross-section, previously 20 x 30 mm. Other cervical lymph nodes are unchanged. The salivary glands and thyroid are unremarkable. There is no evidence of acute infarction. The orbits are unremarkable. The cervical spine is intact. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation.
Marked interval decrease in size necrosis of the left nasopharyngeal tumor right level 2B lymphadenopathy with necrosis, consistent with treatment response.