History of supraglottic laryngeal cancer. Status post chemo/RT ending on 2 -- 8 -- 08. CT of the soft tissues of the neck with infusion:Images through the skull base and including cavernous sinuses remain normal. Paranasal sinuses and mastoid air cells are unremarkable.Images through the neck demonstrate extensive post therapy changes. Soft tissue thickening (right greater than left) is again identified with no interval change since prior exam as well as a study from 2 -- 3 -- 2009.Significant soft tissue thickening at the level of left cuneiforms sinus with mass effect is again identified. This finding is similar in appearance to the immediate prior study from 7 -- 5 -- 2009 as well as to -- 3 -- 2009. No distinct measurable tumor is identified however possibility of residual tumor within these regions cannot be entirely ruled out. Stable appearance of this findings on two prior consecutive studies is not suggestive of recurrence of tumor. Two entirely exclude recurrence of disease in this case an MRI is recommended.There is no evidence of any pathologic adenopathy in the neck. Limited images through the apices of the lungs and mediastinum are negative. No evidence of osseous metastatic lesions.CT of brain with infusionNo evidence of metastatic disease to the brain or the leptomeninges. Cortical sulci, ventricular system and all CSF cisterns remain within normal. Calvarium is intact. 80 cc of Omnipaque 350 was utilized for the above studies.
1.Negative CT of brain and calvarium for metastatic disease. Normal CT of brain.2.Extensive post therapy changes. Soft tissue thickening in the supraglottic/glottic regions remains stable since prior two studies. Further follow-up with an MRI is recommended to entirely exclude possibly two of residual tumor.3.No evidence of pathologic adenopathy in the neck.