T4b N2b parotid gland carcinoma with skull base and facial nerve invasion s/p parotidectomy with right radical neck dissection which revealed carcinoma originating from ex-pleomorphic adenoma with positive margins, perineural invasion and 10/50 positive lymph nodes, here for a regular follow up after C5/5 of TFHX completed on 2/28/13. There are unchanged post-treatment findings related to radiotherapy, as well as right parotidectomy and neck dissection. There is persistent diffuse enhancement and mild enlargement of the mastoid, tympanic, and geniculate ganglion segments of the right facial nerve. There is no evidence of measurable mass lesions in the neck or significant upper cervical lymphadenopathy. The remaining major salivary glands are unremarkable. There is persistent right tympanomastoid fluid. The major cervical flow voids are grossly intact. There is mild degenerative cervical spondylosis without significant spinal canal stenosis. There is T2 hyperintense signal within the subcutaneous tissues of the face bilaterally, which likely represents cosmetic filler.
1.Post-treatment findings in the neck with persistent right enhancement of a portion of the facial nerve, which is compatible with perineural tumor involvement.2. No evidence of significant lymphadenopathy in the upper neck.3. Right tympanomastoid fluid may be related to Eustachian tube dysfunction.