60-year-old male with a history of tongue cancer presents with seizures. Motion degraded examination. No restricted diffusion to suggest acute ischemia. No intracranial hemorrhage. No intracranial mass or mass-effect. The ventricles are within normal limits in size and configuration. Several foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild chronic small vessel ischemic changes. Brain parenchyma is otherwise unremarkable for age. No abnormal parenchymal or meningeal enhancement. Major flow-voids are preserved.Sella and orbits are grossly within normal limits. Note is made of bilateral lens implants. There are bilateral maxillary mucous retention cysts. Note is made of bilateral mastoidectomies. There is a 13 x 21 mm cystic lesion in the preauricular soft tissues along the superficial aspect of the left parotid gland. Bone marrow signal and extracranial soft tissues are otherwise within normal limits.
1. No evidence of intracranial metastases.2. Cystic lesion in the preauricular soft tissues just superficial to the left parotid gland may reflect a benign cystic lesion such as an inclusion cyst. However, a necrotic lymph node cannot entirely be excluded.3. Mild chronic small vessel ischemic changes.