37-year-old male with a salivary cancer. Status post 4 cycles of treatment. Compare and provide measurement. CT of soft tissues of the neck with infusion:Large destructive mass involving the left ethmoid air cells and with extension into the left orbit is again noted. In comparison with the prior exam there may be slight increase in the size of tumor in the retro-orbital space. Extensive tumor across the midline into the right ethmoid air cells with extensive bony erosion is also noted. This section of tumor demonstrates no definitive interval change. Erosion of the anterior wall of the sphenoid sinus with extension of tumor remains a stable. Increased soft tissue density on the lateral aspect of right orbit and right infratemporal fossa also remains a stable. Extensive posttherapy/surgical changes remains stable. No evidence of pathologic adenopathy in the neck. Limited images of the apices of the lungs are negative. Limited images of the mediastinum are negative on this study. Please review the dictated report of CT of chest that visualizes both these sections with more accuracy.CT of brain with infusion.No evidence of hemorrhage, edema, mass effect, midline shift or hydrocephalus. No evidence of abnormal enhancement of brain parenchyma or leptomeninges. To better evaluate patient's known tumor at the skull base in particular for epidural spread into the intracranial space an MRI is recommended.
1. With the exception of possible minimal increase in the left the retro-orbital tumor this is study remains a stable.2.Unremarkable CT of brain. Three see above comments.