Recurrent/metastatic nasopharyngeal cancer, status post treatment. There are post-treatment findings in the nasopharyngeal region. There is no gross residual right cavernous sinus region tumor. There is persistent enhancement within the right foramen rotundum and Vidian canal, as well as in the right sphenopalatine foramen region. There is no evidence of acute infarct. The brain parenchyma appears unremarkable, aside from minimal, nonspecific, scattered, punctate T2 hyperintense foci in the cerebral white matter. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable.
1. No gross residual right cavernous sinus region tumor. 2. Persistent enhancement within the right foramen rotundum and Vidian canal, as well as in the right sphenopalatine foramen region may represent residual treated tumor with perineural extension.