9 year-old female with rhabdomyosarcoma of the nasal cavity now with METs to brain to evaluate for further METs This is a suboptimal study for soft tissue lesion due to no contrast media is used.Limited view of the brain demonstrate right frontal lobe soft tissue mass with vasogenic edema, midline shift to the left and hydrocephalus. Please refer to the dedicated MRI examination for more details.Non-enhancing CT demonstrates a soft tissue mass in superior nasal cavity and ethmoid sinus with possible extension to the right orbital cavity. The ethmoid bone, fovea ethmoidalis, cribriform plates, right lamina papyracea and anterior clinoid process show erosion and loss of continuity. Mucosal thickening is seen in the right maxillary sinus, opacification of the left maxillary sinus, sphenoid sinuses and frontal sinuses are seen.Views of soft tissue neck shows numerous lymph nodes in bilateral posterior triangle, jugular chain, submandibular and submental regions. One in the left jugulodigastric lymph nodes measures 17.3-mm. it is hard to differentiate all those lymph nodes due to lack of contrast. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are patent.
Soft tissue mass in superior nasal cavity and ethmoid sinuses with multiple bony destruction and occlusive paranasal sinuses inflammatory change as detailed above.Intracranial extension better seen on MR and CT. Neck lymphadenopathy as detailed above.