Nasopharyngeal carcinoma, s/p induction. Neck: There is a left nasopharyngeal mass that measures up to approximately 4 cm, previously approximately 5 cm. The tumor also now appears necrotic. The tumor abuts the carotid sheath, but there is no evidence of intracranial extension or skull base erosion. There is decreased narrowing of the nasopharyngeal airway. There are secretions in the right lateral nasopharyngeal recess. A cystic or necrotic right level 2B lymph node measures 20 x 30 mm in axial cross-section, previously 22 x 34 mm. Other smaller cervical lymph nodes are unchanged. The salivary glands and thyroid are unremarkable. There is no evidence of acute infarction. The orbits are unremarkable. The cervical spine is intact. Brain: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation.
1. Interval decrease in size and development of necrosis of the left nasopharyngeal tumor. 2. Slight interval decrease in size of the right level 2B lymphadenopathy.