56-year-old male with squamous cell carcinoma of the right neck. Status post right neck dissection. Evaluate status. CT of the soft tissues of the neck with infusion:Images through the skull base and including cavernous sinuses are unremarkable. Paranasal sinuses and mastoid vessels are unremarkable with the exception of a small retention cyst within the right maxillary sinus. Limited images through the orbits demonstrate thickening of the right lateral rectus muscle with enhancement. This is best appreciated on axial images 11 through 13. The rest of extraocular musculature remain within normal size and morphology. Please correlate with history and follow-up with an MRI examination of orbits is recommended.The finding may represent Graves' disease. Possibility of a post traumatic change cannot be ruled out. A less likely possibility of a mass should also be considered. MRI is recommended.Images through the soft tissues of the neck demonstrate prominence of bilateral tonsils with multiple calcification which may be result of prior repetitive infection. There is effacement of partial plane on the right secondary to prior surgical intervention. No definitive evidence of a primary tumor is detected. No definitive pathologic adenopathy is identified.Limited images through the apices of the lungs and mediastinum are negative. Please review dedicated report of CT of chest performed the same date.Bony density of area of exam is unremarkable however degenerative disk disease of the cervical spine is noted.CT of brain with infusion:No evidence of hemorrhage, edema, mass-effect, midline shift or hydrocephalus. Cortical sulci, ventricular system and all CSF cisterns remain within normal limits. No evidence of metastatic disease to the brain, leptomeninges or the calvarium.80 cc of Omnipaque 350 was utilized for a bone studies.
1.No definitive mass or pathologic adenopathy in the neck.2.Post operative changes of right neck.3.Prominence of right lateral rectus muscle as detailed above. MRI is recommended.4.Unremarkable CT of brain with infusion.