46 years, Female, Reason: h/o Acinic cell carcinoma of the parotid and chemoradiation Again seen are postoperative findings related to right parotidectomy. Interval postsurgical changes of partial mastoidectomy are seen with mild increase in surrounding enhancement which may reflect granulation tissue. No significant change in the remainder of the ill-defined heterogeneously enhancing mass that involves the right basiocciput, petrous ridge, mastoid portions of the right temporal bone, and condylar and lateral squamous portions of the occipital bone. The central areas of non-enhancement within the mass likely represent necrosis and are not significantly changed. The mass still abuts the right ICA and encases the right internal jugular vein. There is also unchanged abnormal enhancement within the lateral mass of the C1 vertebra. Diffuse heterogeneity of the bone marrow signal in the remainder of the calvarium is similar to prior and nonspecific.There is no evidence of intracranial hemorrhage or acute infarct. There is no appreciable mass effect upon the cerebellum or brainstem. There are a few unchanged nonspecific foci of T2 hyperintensity in the cerebral white matter. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The orbits are unremarkable. The remaining salivary glands are unremarkable.
Compared to 4/29/2015 interval postsurgical changes of partial mastoidectomy for debridement related to osteoradionecrosis is seen. There is mild increased surrounding enhancement likely reflecting postsurgical change/granulation tissue. Otherwise there is no significant change in appearance of the heterogeneously enhancing necrotic mass centered at the right lateral skull base and craniocervical junction consistent with treated tumor.