Plexiform tumor of left side of neck with facial involvement and left sided weakness History: large plexiform tumor of left side of face and neck and facial weakness. There is an infiltrative mass centered in the right pterygopalatine fossa with extension into the foramen ovale, foramen rotundum, Vidian canal, right cavernous sinus, posterior right nasal cavity, buccal space, and protrudes slightly into the right orbit via the inferior orbital fissure. Overall, the tumor measures up to approximately 7 cm. There is right tympanomastoid fluid. There is a partially-imaged transpatial mass centered in the posterior triangle of the left lower neck, which measures at least up to 10 mm. Furthermore, tumor extends into the left C5 though at least the T2 neural foramina, but there does not appear to be spinal cord compression. There are postoperative findings related to laminotomies from C5 to T1. There is kyphotic deformity at the cervical thoracic junction, but no spondylolisthesis. There is a punctate T2 hyperintense lesion in the left upper lip. There is diffuse moderate paranasal sinus mucosal thickening. There is no significant cervical lymphadenopathy. There is mild prominence of the Waldeyer ring structures, which is a common finding for the age of the patient.
1. A plexiform neurofibroma centered in the right pterygopalatine fossa with extension into the foramen ovale, foramen rotundum, Vidian canal, right cavernous sinus, posterior right nasal cavity, and buccal space. Overall, the tumor measures up to approximately 7 cm. Right tympanomastoid fluid may represent retained effusions due to mass effect upon the Eustachian tube. 2. A partially-imaged transpatial plexiform neurofibroma centered in the posterior triangle of the left lower neck measures at least up to 10 mm. Furthermore, tumor extends into the left C5 though at least the T2 neural foramina, but there does not appear to be spinal cord compression. Please refer to the separate chest MRI report for additional details.3. Kyphotic deformity at the cervical thoracic junction, but no spondylolisthesis. 4. A punctate T2 hyperintense lesion in the left upper lip may represent a neurofibroma.