Status post surgery and radiotherapy for left carotid cancer (carcinoma ex pleomorphic adenoma with perineural invasion), with left neck pain and spasm. There are post-treatment changes related to the left parotidectomy and radiotherapy, which may account for the persistent signal abnormality within the left mandible bone marrow. However, there are no mass lesions in this region suggestive of residual/recurrent disease. There is no significant lymphadenopathy in the neck. There is a small right upper lip skin excrescence. The remaining salivary glands, nasopharynx, oropharynx, hypopharynx, and larynx are unremarkable. There are unchanged nodules within the thyroid. There is a carious tooth number 19. The imaged intracranial structures are orbits are unremarkable. There is anterior surgical fusion of C4-6 and degenerative spondylosis of the cervical spine.
Post-treatment findings related to left parotidectomy and radiation with no evidence of measurable locoregional tumor recurrence of significant cervical lymphadenopathy, although the assessment is limited by the lack of intravenous contrast. Persistent signal abnormality within the left mandible bone marrow may be treatment-related, such as osteonecrosis.