History of papillary thyroid cancer and metastatic EBV associated nasopharyngeal carcinoma to the lung status post radiotherapy, which was completed in 3/2014 and surgery and radiotherapy for the lung metastasis completed in 10/2014. There is no appreciable residual nasopharyngeal mass. The skull base and cavernous sinuses appear to be intact. However, there is fat signal intensity in the regional bone marrow, which is likely attributable to radiation therapy. There are new bubbly T1 and T2 hyperintense secretions in the left sphenoid sinus. There is no significant lymphadenopathy in the imaged portions of the neck. There is a subcentimeter cystic lesion associated with the right temporomandibular joint. The lesion in the left midbrain has involuted. The lesion now measures up to 3 mm, previously 5 mm. There is no associated enhancement or associated surrounding edema. However, a lesion in the anterior right frontal lobe with an associated developmental venous anomaly has increased in size and contains a hematocrit level with T1 hyperintensity. There is an unchanged enhancing extra-axial mass overlying the left middle frontal gyrus that measures up to 7 mm in width with associated calvarial hyperostosis. The orbits are unremarkable.
1. No evidence of recurrent nasopharyngeal tumor.2. A cavernous malformation in the anterior right frontal lobe has increased in size due to interval subacute hemorrhage.3. Further decrease in size of the left midbrain cavernous malformation that previously hemorrhaged. 4. The extra-axial lesion overlying the left middle frontal gyrus is unchanged and likely represents a meningioma.5. Right temporomandibular joint synovial cyst.6. New secretions in the left sphenoid sinus may represent sinusitis.