Left orbital rhabdomyosarcoma. Partially resected in March 2014. Treated with chemotherapy and proton beam therapy. In remission. The infiltrative signal abnormality involving the left lacrimal fossa and the superior and lateral extraconal aspects of the left orbit has minimally diminished since the previous examination. The associated contrast enhancement is also slightly decreased. There is no evidence of a discrete tumor, however. The minimal thickening and bone marrow T1 hyperintensity in the region of the sphenoid triangle is unchanged, probably reactive. The rest of the left orbit is unremarkable. Focal T2 hyperintensity in the left lateral, inferior aspect of sphenoid body is unchanged and may represent variant pneumatization or other benign entity. The right orbit is normal. The included portions of the brain appear unremarkable. Mucosal thickening in the sphenoid and maxillary sinuses has increased since the previous examination. In addition, mucosal thickening in the mastoid air cells has increased and is worse on the left.
1. Post-treatment findings in the left orbit without evidence of locally recurrent tumor.2. Increased diffuse paranasal sinus inflammation.3. Nonspecific inflammatory changes in the bilateral mastoid air cells may represent mastoiditis.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.