Follow-up of stage IV mucosal melanoma with large infiltrating mass in the maxillary sinus as well as metastatic disease status post radiation therapy to the sinus mass, now on Ipilimumab. There are post-treatment findings in the left sinonasal region. There is an mildly and heterogeneously enhancing mass centered in the medial left maxillary sinus with extension into the infundibulum and left maxillary alveolus, as well as slight extension into the inferior extraconal left orbit and into an expanded left pterygopalatine fossa with involvement of the anterior portions of foramen rotundum and Vidian canal. Overall, the mass measures up to approximately 5 cm. There are otherwise obstructed secretions in the left lateral maxillary sinus, ethmoid air cells, and sphenoid sinuses. There is a nonspecific subcentimeter lesion in the left nasal ala. There is diffuse enhancement of the left masticator muscles with otherwise preservation of the architecture, indicative of denervation effects. There is a subcentimeter left vallecular retention cyst. There is no evidence of significant lymphadenopathy in the imaged portions of the neck. The major salivary glands appear to be intact. The imaged intracranial structures are unremarkable.
1. A mass centered in the left maxillary sinus is compatible with melanoma and superimposed treatment effects. The mass measures up to approximately and extends into surrounding spaces, including the left orbital periosteum and pterygopalatine fossa with evidence of perineural spread in the central skull base region. Previous studies are currently unavailable in the University of Chicago PACS, which precludes comparison to prior disease status.2. Nonspecific subcentimeter left nasal ala lesion.