69-year-old male. Follow-up after ESS subtotal removal of left maxillary sinus mass (final path solitary fibrous tumor). Patient with persistent disease extending into the orbit. This is limited by motion because of sleep apnea, accentuated by oral sedative that the patient took prior to the procedure.The lobulated, solid contrast enhancing mass involving the left orbit with extension into left nasal cavity and left maxillary sinus as well as adjacent retromaxillary and premaxillary spaces (through erosion of the maxillary sinus walls) has progressed in size since the previous examination. In the axial plane, it measures maximally 4.6 cm x 4.2 cm (image #16 of series #10) compared to 3.9 cm x 2.9 cm previously (image #7 of series #401). On the coronal images, it has a maximum dimension of 5.2 cm (image #18 of series #15) compared to 4.8 cm previously (image #12 of series #1801). The associated left proptosis has slightly increased as well as the stretching of the left optic nerve which is draped over the superior aspect of the mass but is not encased or invaded. The mass causes more narrowing of the left nasal cavity. The mass abuts and mildly deforms the anterior and of the left temporalis muscle. There is no direct involvement of the pterygopalatine fossa, second division of the trigeminal nerve or cavernous sinus. There is no intracranial extension of the mass. On diffusion-weighted imaging, the mass has diffusion characteristics that are slightly more restricted compared to the brain gray matter. Osseous destruction along the floor of the left orbit and along the maxillary sinus wall is better assessed on the previous CT scan dated April 2, 2015.Associated mucosal thickening in the remaining part of the left maxillary sinus is reactive/inflammatory and has not changed. Changes of previous endoscopic sinus surgery and partial tumor resection are present. The included brain shows no abnormality.
Compared to the June 2015 examination, the mass involving the left orbit, left maxillary sinus, and left nasal cavity demonstrates mild interval enlargement as detailed above. No intracranial extension. 