History of poorly differentiated sinonasal carcinoma SNUC s/p CRT. The patient also has a history of ankylosing spondylitis with sacro-iliac fusion and evidence of a C5-6 impingement. MRI Face/Sinuses: There are postoperative findings related to sinonasal tumor excisional biopsy with resection of the left ostiomeatal complex and left middle and superior turbinates. No evidence of recurrent or residual tumor is noted. There is persistent mucosal and secretions that completely fill the left sphenoid sinus. There is persistent moderate mucosal thickening in the left maxillary sinus and mild mucosal thickening within the right maxillary, right sphenoid, and right ethmoid sinuses. There is a mildly prominent left level 2A lymph node that measures 8 mm in short axis, but otherwise, there no evidence of significant cervical lymphadenopathy. The salivary glands are unremarkable. There is encephalomalacia in the inferior right cerebellar hemisphere and diffuse volume loss of the imaged brain. There are bilateral lens implants. MRI Cervical Spine: There is diffuse mild congenital narrowing of the cervical spinal canal. There is mild anterior syndesmophyte formation at multiple lower cervical and imaged thoracic vertebrae. There is degenerative spondylosis of the cervical spine that is most pronounced at the C5-6 level with areas of uncovertebral and facet hypertrophy. There is also a mild disc-osteophyte complex with resultant moderate to severe right-sided and moderate left-sided neuroforaminal stenosis at this level, as well as mild indentation upon the spinal cord. The spinal cord displays normal signal and morphology. The vertebral column alignment is within normal limits. The vertebral body heights are preserved. The vertebral bone marrow signal is unremarkable. The paravertebral soft tissues are unremarkable.
1. Post-treatment findings in the sinonasal region with persistent diffuse mucosal inflammatory changes, but no convincing evidence of gross tumor recurrence, although the images are degraded by patient motion. 2. Stigmata of ankylosing spondylitis, a congenitally narrow spinal canal and superimposed cervical spine degenerative spondylosis that is most severe at the C5-6 level where uncovertebral/facet hypertrophy causes moderate to severe right and moderate left neuroforaminal stenosis. 3. Chronic right PICA territory infarct.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.