81 year old female with left masticator space sarcoma, follow-up A large heterogenous enhancing soft tissue mass is identified centered at the left masticator space. The medial and lateral pterygoid muscles are involved. The masseter muscle has been displaced laterally. No clear margin is seen between the lesion and the masseter muscle. Posteriorly, the mass infiltrates the left parotid space and displaced the retromandibular vein posteriorly. Both lateral and medial cortex of the mandible are eroded, including the left mandibular foramen. Medially, the parapharyngeal space is partially effaced. Superiorly, the lesion extends along the CN V mandibular nerve, through the foramen ovale and filling the left Meckel's cave. The foramen ovale is enlarged and cortex is eroded. The lesion is measuring 4.4 x 4.7 x 5.1 cm on axial image 28 series 3 and image 33 series 80248. No pathologic lymphadenopathy is appreciated based on the size criteria for lymphadenopathy. The oral cavity, oro/nasopharynx, hypopharynx, larynx and subglottic airways are patent. The epiglottis, vallecula, piriform sinuses, and vocal cords are normal. Tiny hypodense lesions in the thyroid glands. Correlate with ultrasound exam. The parotid and submandibular glands are unremarkable. The carotid arteries and jugular veins are patent. Scarring and small nodules are noted in the lung apices. Please refer to the dedicated chest CT for more comments. There is redemonstration of extensive degenerative change in the cervical spine including grade I retrolisthesis of C5 on C6, C4/5 to C6/7 multilevel neural foramina narrowing and C4/5 and C5/6 central canal stenosis. Please refer to dedicated MRI of the cervical spine acquired at other institute for more details. A large intraosseous hemangioma is again noted in the C6 vertebral body.
1. Large heterogenous enhancing soft tissue mass centered at the left masticator space with perineural extension into the Meckel's cave. A MRI study is recommended to further evaluate intracranial spread.2. There is no pathologic lymphadenopathy.3. Extensive degenerative change in the cervical spine with multilevel neural foramina narrowing and central canal stenosis. Please refer to dedicated MRI of the cervical spine acquired at other institute for more details. 4. Scarring and small nodules are noted in the lung apices. Please refer to the dedicated chest CT for more comments. 