T4N2, WHO type III, nonkeratinizing EBV+ nasopharyngeal cancer, status post treatment. Orbits: The globes, ocular adnexa, optic nerves, and orbital fat are unremarkable, without evidence of intraorbital mass lesions. There are post-treatment findings in the nasopharyngeal region, where there is diffuse swelling and associated persistent enhancement of the central skull base, but no measurable residual tumor in the soft tissues. There is diffuse paranasal sinus mucosal thickening and fluid within the bilateral maxillary sinuses and left sphenoid sinus. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is fluid within the bilateral mastoid air cells.
1. Extensive post-treatment findings in the nasopharyngeal region without definite evidence of measurable tumor progression in this area and no evidence of intraorbital lesions. 2. Persistent enhancement of the central skull base is likely related to sequela of skull base invasion by the tumor and superimposed treatment-effects.3. Inflammatory changes in the paranasal sinuses with evidence of acute sinusitis.4. Persistent bilateral otomastoid effusions, which may be attributable to Eustachian tube dysfunction.5. No evidence of brain metastases.