Clinical question: History of metastatic salivary gland cancer. Evaluate new pulmonary mass. Measurements please. Signs and symptoms: None Enhanced CT of soft tissues of neck:Limited images of the intracranial contents demonstrate a high density mass (likely an enhancing) in the right posterior temporal lobe measuring 12.2 x 12.4 millimeters in transaxial dimension (axial image 15 of 91) follow-up with dedicated CT or MRI exam is recommended.Images through the skull base, cavernous sinuses, bilateral petrous bones and paranasal sinuses are negative.Enhancement along the fascial planes in the left infratemporal fossa are likely result of anatomical venous and structures. This finding is best appreciated on axial image 23. This finding was also noted on prior study.There is evidence of complete right-sided parotidectomy with no evidence of recurrence of tumor.Extensive postoperative changes of neck are noted however no evidence of a mass is detected.There is a nonenhancing left-sided lymph node at the level of hyoid bone measures 8.8 x 6.3 mm in transverse axis and 16.8-mm in cranial -- cephalad axis. This node shows no interval change since prior exam.Images through the neck are otherwise unremarkable.There is limited images of the bases of the lungs demonstrate a large right apical mass measuring 43.5 x 31.3-mm in transaxial dimension and approximately 34 mm in cardial/cephalad axis. There is also a very large mediastinal mass which surrounds the trachea and is only partially visualized. This mass measures 55-mm in AP axis and 61-mm in transverse axis. Please review the dictated report of CT of the chest for more detailed information.60 cc of Omnipaque 250 is administered.
1.No detectable tumor in the neck. Nonenhancing lymph node in the left neck at the level of the high a bone measuring 8.8 x 6 in transaxial dimensions and 16.8-mm in cardial slice cephalad axis. There is no detectable change since prior examination from an outside institution as described above.2.Limited view of intracranial space demonstrate a high density mass measuring 12.4 x 12.2-mm in size in the right posterior temporal. This is highly suspected for intracranial metastatic lesion.3.Right upper lung field tumor measuring 43.5 x 31.3 in transaxial and 34-mm in cranial cephalad. Large additional right-sided mediastinal tumor measuring 61 x 54.5-mm in transaxial dimensions.