History of base of tongue cancer. Status post chemo/RT finishing 8 -- 12 -- 2004 CT of the soft tissues of the neck.Images through the skull base and cavernous sinuses demonstrate prominence of the lateral ventricles stable since prior study. New since prior examination is erosive changes of the posterior aspect of dens and body of C2 vertebrae. There is also associated soft tissue thickening and enhancement along the ventral aspect of the spinal canal at this level. This soft tissue also appears to extend between the dens and inferior tip of the clivus. The finding is concerning for metastatic disease and a follow-up with an MRI examination is recommended. There is slight compromise of the AP diameter of thecal sac at this level due to epidural soft tissue mass which causes slight flattening and posterior displacement of the cord and borderline central spinal stenosis of 7.5 mid. These findings are best appreciated on the reformatted sagittal images and also axial post infusion image 28 through 32.No evidence of recurrence of tumor at the level of base of tongue is detected. There is also no evidence of any pathologic adenopathy in the neck. No evidence of any additional osseous abnormality is detected. Extensive degenerative changes of cervical spine are noted. Limited images through the apices of the lungs demonstrate apical scarring. No evidence of metastatic nodules within the lung or limited view of mediastinum is detected.CT of brain with infusion:Visualization of ventral epidural soft tissue at the level of foramen magnum as detailed above.No evidence of hemorrhage, edema, mass effect or midline shift. Prominent supratentorial ventricular system remains stable since prior study. Normal density of brain parenchyma and no evidence of abnormal enhancement.The above new findings where discussed with Dr. Nwizu, Tobenna with pager number 2703 at the time of interpretation.70 cc of Omnipaque was utilized for this exam.
1.Stable CT of brain with infusion.2.Erosive changes along the dorsal aspect of C2 vertebral body with extra osseous enhancing soft tissue as detailed. Follow-up with a dedicated MRI of cervical spine is recommended to rule out metastatic lesions.3.No evidence of recurrence of tumor at the tongue base or any pathologic adenopathy in the neck.