Grade 2 olfactory esthesioneuroblastoma treated with recent radiation/chemo/surgery. Face: There are interval post-operative findings related to right medial maxillectomy and right anterior and posterior ethmoidectomy. There is moderate mucosal thickening in the right maxillary sinus, ethmoid, and frontal sinuses. There is a small area of relative T2 hypointensity and hypoenhancement in the right superior anterior ethmoid surgical bed, but otherwise no evidence of gross residual tumor in the rest of the sinonasal region. There is leftward nasal septal deviation. There are findings related to right dacryocystorhinostomy, but the orbits are otherwise grossly intact. There is a subcentimeter Thornwaldt or nasopharyngeal retention cyst.Brain: There is no evidence of intracranial extension of tumor. There is a prominent perivascular space in the right basal ganglia. The brain parenchyma otherwise appears unremarkable and there is no evidence of acute infection or 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.
1. Interval sinonasal surgery with a small area in the right superior anterior ethmoid surgical bed that has features that resemble the original tumor, which may therefore represent a small amount treated tumor versus cauterized tissue amidst moderate right sinonasal mucosal inflammation, but otherwise no evidence of gross residual tumor in the rest of the sinonasal region.2. No evidence of intracranial tumor.