T4bN0 small cell sinonasal neoplasm status post surgery and radiation. FACE: There are post-treatment findings in the nasopharyngeal and sinonasal regions with a defect in the exosurface of the clivus, which demonstrates diffuse enhancement, as well as prominent mucosal thickening in the bilateral maxillary sinuses and to a lesser extent in the anterior ethmoid cavity. There is diffuse hyperenhancement of the nasopharyngeal mucosal space, but no evidence of discrete mass lesions or significant cervical lymphadenopathy based on size criteria. There is a wide left mandibular molar extraction cavity containing probable granulation tissue. BRAIN: There is no evidence of intracranial hemorrhage, mass, or acute infarct. The brain parenchyma and pituitary gland appear unremarkable. There is no abnormal intracranial enhancement. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull are grossly unremarkable.
1. Post-treatment findings in the nasopharyngeal and sinonasal regions without evidence of measurable mass lesions in the treatment bed. Indeed, diffuse hyperenhancement of the nasopharyngeal mucosal space likely represents mucositis with underlying scar or granulation tissue rather than viable tumor. 2. No evidence of intracranial metastases.