64-year-old female with a history of a nasal mass. Limited examination for preoperative planning purposes.Again seen is a polypoid lesion in the posterior right nasal cavity which measures approximately 3.3 cm in the axial plane, 1.4 cm in the transverse dimension, and approximate 4 cm in the craniocaudal dimension. The lesion demonstrates low T2 signal and homogeneous enhancement. Lesion extends posteriorly into the nasopharynx. The lesion is noted to extend into the anterior aspect of the right sphenoid sinus with widening at the right sphenoethmoidal recess. Subtle foci of thinning along the floor of the anterior cranial fossa are better appreciated on the prior CT examination. There is no evidence of intracranial extension.There is mild mucosal thickening in the bilateral maxillary sinuses as well as a mucous retention cyst in the right sphenoid sinus. There is also minimal opacification involving the anterior and posterior ethmoid air cells.The ventricles and sulci are prominent compatible with age-related volume loss. Several foci of T2 hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with chronic small vessel ischemic changes. Brain parenchyma is otherwise grossly unremarkable on these limited sequences with no abnormal parenchymal or meningeal enhancement.
1. Limited examination done for preoperative planning purposes. Right-sided polypoid lesion in the posterior right nasal cavity with protrusion into the nasopharynx. The lesion demonstrates low T2 signal and homogeneous enhancement, signal features which are suspicious for neoplasm although not specific.2. Lesion appears to extend into the right sphenoid sinus through what appears to be widened sphenoethmoid recess. Subtle foci of thinning along the floor of the anterior cranial fossa are better appreciated on the prior CT. There is no evidence of intracranial extension.3. Mild chronic small vessel ischemic changes.