81-year-old male with history of parotid ACC. Status post chemo/RT Images at the level of the skull base and cavernous sinuses and including paranasal sinuses are unremarkable. Opacification of right mastoid air cells is a new finding since prior study.Postoperative changes of right-sided parotidectomy is again identified. This finding remains stable since prior study and no evidence of recurrence of tumor at the surgical site is detected.No evidence of any masses or pathologic adenopathy in the soft tissues of the neck is detected. Images at the level of the apices of the lungs demonstrate minimal scarring on the left also stable since prior. No metastatic lesion is detected.Bony density of area of exam is negative for metastatic lesions.CT of brain with infusion.This examination demonstrates an enhancing lesion measuring approximately 12.5 mm x 9.3-mm in transaxial dimension within the right cerebellopontine angle. Multiple prior studies were reviewed which failed to demonstrate this finding. This lesion is not associated with any definitive bony changes and is at least partially at the level of the right internal auditory canal which also appears normal in size and morphology. This finding may represent choroid plexus at the level of the right foramina of Luschka, however due to lack of its visualization on prior examination possibility of tumor cannot be excluded and an MRI examination of brain with infusion is recommended to exclude this possibility.This examination is otherwise negative and in particular no evidence of metastatic disease to the brain parenchyma, leptomeninges or the calvarium is detected. Also as noted above there is evidence of interval development of opacification of mastoid air cells on the right side. Small vessel disease again identified.
1.No evidence of recurrence of disease in the neck.2.Extra-axial right CP angle enhancing lesion which may represent choroid plexus of the fourth ventricle at the level of foramina of Luschka however to exclude possibility of tumor an MRI is recommended. This finding was not identified on any of the prior studies.