Surveillance scan for cancer. History of squamous of carcinoma of the scalp with cervical nodal metastasis. Status post surgery and chemoradiation. Developed recurrence in left cervical lymph nodes. Currently on induction chemotherapy. There are findings related to previous left neck dissection and flap reconstruction. The multilobulated tumor recurrence deep to the flap seen on the previous MRI has regressed in size and is more difficult to discern from the overlying flap. Transaxially, it now measures 28 mm x 9 mm compared to 42 mm x 19 mm previously. Additionally, the metastatic soft tissue nodule superficial to the flap at the level of C6 has also regressed, now measuring up to 15 mm, previously measured 21 mm. There is a smaller soft tissue nodule more superiorly just deep to the posterior edge of the flap, which is also smaller, now measuring up to 9 mm compared to 18 mm previously. Otherwise, there is underlying posttreatment soft tissue thickening but no new mass lesions. There is no new cervical lymph node enlargement.Vascular dilatation at the left carotid bifurcation/bulb is unchanged. The airway is patent. Asymmetry at the level of the larynx remains and is probably in part due to prior medialization laryngoplasty.Well-circumscribed focus of T2-hyperintensity in the left mandibular body has not changed and may represent posttreatment change.Multilevel degenerative cervical spondylosis present is unchanged and results in only mild spinal canal stenosis but left more than right lower cervical neural foraminal stenoses.Included brain shows unchanged right frontal encephalomalacia and brain volume loss. Small retention cysts are present in the right maxillary sinus.
1.Since the previous MRI from March 2016, there has been further regression of multiple left cervical soft tissue masses, most probably representing lymph node metastases.2.Other posttreatment findings remain unchanged since the prior examination.