72-year-old male with right nasal high-grade carcinoma, evaluate for possible skull base involvement. There has been interval resection of the previously noted heterogeneously enhancing mass in the posterior right nasal cavity and ethmoid sinuses. No definite residual enhancing tumor is identified. There is a nonspecific thin peripheral rim of enhancing tissue along the expected location of the posterior ethmoid cavity. There is persistent residual bony expansion and minimal mass effect on the medial right orbit.No definite evidence of osseous involvement of the skull base is identified. STIR hyperintensity in the central skull base is compatible with edema and likely related to posttreatment changes. The V3 branch of the right trigeminal nerve is slightly irregular just proximal to the foramen ovale, with low T1 and T2 signal and minimal linear enhancement, which may be related to surrounding vessels.There is minimal mucosal thickening of the right maxillary sinus.Incidental note is made of a small pineal cyst. Prominent area of encephalomalacia and cortical thinning along the left sylvian fissure is compatible with chronic infarct.
Interval resection of posterior right nasal cavity and ethmoid sinus mass, with no definite residual enhancing disease or evidence of osseous involvement. Nonspecific thickening along the expected location of the right posterior ethmoid cavity is likely postoperative in nature given absence of abnormality in this area on the preoperative exam, but attention to this area on subsequent imaging is suggested to exclude recurrent tumor.