Reason: T3N2b right BOT HPV+ SCC on OPTIMA trial, finished induction chemotherapy with carboplatin/abraxane on 8/26/16. Evaluate for response. Need measurements Again seen is infiltrative enhancing lesion centered on the right base of tongue and extending into the oral tongue and floor of mouth anteriorly and posteriorly involving the glossotonsillar sulcus and right tonsillar fossa. Enhancing lesion measures 41 x 19 mm (axial postgad series 1601 image 39) previously 44 x 22 mm measured in a similar plane. A right level 2A lymph node measures 9 x 13 mm, axial T1 series 1201 image 38, which was previously 12 x 15 mm. There are additional scattered small cervical lymph nodes which are not significant by size criteria. There is motion degradation on multiple sequences however no new masses or new cervical lymphadenopathy is appreciated. Airway remains patent. There is suggestion of increased T2 hyperintensity in the right hemitongue which may represent early denervation changes.Visualized intracranial structures are unremarkable. No MRI evidence of perineural tumor spread. Visualized brain and orbits are gross the unremarkable. Paranasal sinuses are also clear aside from small bilateral maxillary mucus retention cyst.
Compared to MRI dated 6/25/2016 there is mild decrease in size of the right base of tongue mass as well as decrease in size of a right level 2 cervical lymph node.