Childhood radiation and a nerve sheath tumor of the right skull base. Denies headaches, voice or swallowing changes. Neck: There is no significant interval change in the well-defined lobulated, enhancing mass that measures up to approximately 42 mm within the right post-styloid parapharyngeal space, with extension into prevertebral space and widened C1-occipital neural foramen, with associated remodeling of the right lateral C1 arch. The mass protrudes slightly into the epidural space, but does not compress the spinal cord. The mass displaces the carotid artery anteromedially and abuts and possibly encases the right vertebral artery. The mass also compresses the internal jugular vein, which is displaced posteriorly. The pharyngeal mucosal space is intact. There is no significant cervical lymphadenopathy. The salivary gland and thyroid are unremarkable. There is multilevel degenerative cervical spondylosis.Brain: There is an unchanged subcentimeter well-defined T2 hyperintense, enhancing lesion within the right cerebellomedullary angle. The left medial temporal lobe cavernous malformation and associated developmental venous anomaly are unchanged. There is a small right superior frontal gyrus developmental venous anomaly. A few scattered punctate foci of white matter T2 hyperintensity are unchanged and nonspecific. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation.
1. No significant interval change in the mass that measures up to approximately 42 mm within the right post-styloid parapharyngeal space, with extension into prevertebral space and widened C1-occipital neural foramen. 2. A subcentimeter lesion within the right cerebellomedullary angle is unchanged. These lesions likely represent peripheral nerve sheath tumors.3. The left medial temporal lobe cavernous malformation and associated developmental venous anomaly are unchanged.