50 year-old female with history of pharynx cancer, melanoma. Evaluate for recurrence. Rule out long metastases CT of soft tissues of the neck with infusion:Images through the skull base and including cavernous sinuses remain within normal limits. Mastoid air cells and paranasal sinuses are unremarkable.Images through the neck demonstrate extensive posttherapy and surgical changes on the left side of the neck.Postoperative changes at the level of the left hypopharyngeal wall, left submandibular region and extending to the floor of the mouth and region of the left piriform sinus is associated with some soft tissue fullness in these regions. In comparison with the prior examination there is suggestion of possible slight reduction in the amount of soft tissue fullness in history area. I detect no definitive tumor in this location. Significant distortion of the anatomical landmarks and soft tissue adhesion in the surgical site makes precise evaluation difficult with however as mentioned above no definitive evidence of tumor is detected. This recurrence of tumor is concerned follow up with PET scan or an MRI is recommended. A submental node in the midline is again identified and measures 12.2 x 13.4-mm which is identical to prior examination.No evidence of any pathologic adenopathy in the neck is detected. The bony structures of the area of exam are unremarkable.Limited images of the apices of the lungs demonstrate minimal apical scarring.Limited view of mediastinum is negative. Please review the dictated report of CT of chest performed the same date.CT of brain with infusion:Examination demonstrate no abnormal enhancement of the brain parenchyma or leptomeninges. Cortical sulci, ventricular system and all CSF cisterns remain within normal. Calvarium is intact. No definitive evidence of any abnormality of the soft tissues of the scalp is identified60 CT of Omnipaque 350 was utilized for the above studies.
1.No detectable tumor or or pathologic adenopathy in the neck.2.Stable prominent submental node as detailed.3.Negative CT of brain and calvarium with infusion.