T4N0 adenoid cystic carcinoma of minor salivary gland/maxillary sinus with intracranial extension. There has been interval partial left maxillectomy. There is diffuse mild left maxillary sinus mucosal thickening, with persistent patchy enhancement in the underlying left maxillary alveolus and retromaxillary region. There is also persistent perineural tumor extension involving the left infraorbital nerve, pterygopalatine fossa, Vidian canal, foramen rotundum, foramen ovale, and cavernous sinus, as well as along the cisternal segment of the left trigeminal nerve, but no evidence of intraparenchymal extension. There is also persistent enhancing tumor within the medial left extraconal orbit, which measures up to 6 mm in width. There is no discernible residual right pituitary tumor. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is no evidence of significant cervical lymphadenopathy based on size criteria. The thyroid and major salivary glands are unremarkable.
1. Interval post-treatment findings in the left sinonasal region with persistent perineural tumor involving the left trigeminal nerve branches with intracranial extension, as well as persistent patchy enhancement in the underlying left maxillary alveolus and retromaxillary region. 2. Persistent left medial orbit extraconal tumor.3. No evidence of brain parenchymal metastases.