Relapsed neuroblastoma. The lobulated heterogeneous mass along the floor of the left middle cranial fossa and infratemporal fossa with perineural extension into the left cavernous sinus through foramen ovale and rotundum is not significantly changed, measuring up to approximately 4 cm. However, tumor along the left lateral extraconal space appears to have slightly increase in size, measuring up to 7 mm in thickness, previously 6 mm, with mass effect upon the left lateral rectus muscle and narrowing of the optic canal and apex. However, the left optic nerve signal characteristics are preserved. Likewise, an extradural enhancing nodule adjacent to the inferior left frontal lobe laterally has not significantly changed in size. There is interval decrease in size of the tumors along the bilateral mandibular condyles. There is no evidence of intracranial hemorrhage or acute infarct. There is mild mega cisterna magna. Otherwise, the ventricles and basal cisterns are normal in size and configuration. There is no midline shift. There is scattered paranasal sinus mucosal thickening and secretions. There is obstructed fluid within the left mastoid air cells.
1. Perhaps slight interval increase in size of tumor along the left lateral wall of the orbit.2. No significant interval change in the mass along the floor of the left middle cranial fossa and infratemporal fossa with apparent perineural extension into the left cavernous sinus through foramen ovale and rotundum, as well as associated left Eustachian tube obstruction.3. A subcentimeter extradural lesion adjacent to the inferior left frontal lobe laterally has not significantly changed in size.4. Interval decrease in size of the tumors along the bilateral mandibular condyles.