45-year-old male with maxillary sinus cancer. To status post chemo. Evaluate disease compared to the prior study. CT of the soft tissues of the neck.A very large destructive mass within the bilateral ethmoid sinuses with extension bilaterally into the orbits (right greater than left with significant mass-effect on the optic nerve), sphenoid sinus, nasal cavity, right maxillary sinus with extensive bony destruction is again identified. The mass at the level of skull base causes erosion and extends into bilateral subfrontal extra-axial space. No definitive evidence of any parenchymal edema is detected. In comparison with the prior exam no appreciable interval change in the size of this tumor is detected. The mass on the right involves the right pterygopalatine fossa. No abnormality of the cavernous sinus can be detected on this exam. If this area needs to be further evaluated an MRI examination is recommended.Images through the rest of the soft tissues of the neck demonstrate no pathologic adenopathy.No evidence of spinal column abnormality is detected.Limited images through the apices of the lungs are negative. Limited view of mediastinum is negative for lymphadenopathy. Please review the dictated report of CT of chest performed the same date.CT of brain with infusion.Enhancing mass in bilateral subfrontal region secondary to spread of tumor into the intracranial spaces noted. No areas of vasogenic edema of the frontal lobes is detected. No evidence of enhancement of the brain parenchyma or the leptomeninges is identified. The brain parenchyma remains essentially within normal limits.
1.No definitive evidence of any appreciable change in in the size, morphology or pattern of enhancement of a large destructive mass in bilateral ethmoid air cells, sphenoid sinus, skull base, nasal cavity and right maxillary sinus.2.Bilateral subfrontal tumor spread with no evidence of edema or leptomeningeal enhancement all frontal lobes.3.Unremarkable CT I examination of brain parenchyma and leptomeninges.