Neurofibromatosis 1 with right facial plexiform neurofibroma. There is redemonstration of a diffuse plexiform neurofibroma that infiltrates the entirety of the right temporalis muscle including into the infratemporal fossa and also involves the right frontotemporal scalp and right cheek. The size of this lesion appears similar to the prior studies with the temporalis muscle portion measuring up to 17 mm transverse and the cutaneous scalp/cheek neurofibroma measuring up to 7 mm thick. As before, there appears to be some remodeling of the right sphenoid bone. Anteriorly there is extension to the lateral-most aspect of the orbit without intraorbital involvement. Inferiorly, there is extension to the lateral aspect of the lateral pterygoid muscle within the masticator space, unchanged.Redemonstrated are ill-defined areas of FLAIR hyperintensity in the globus pallidus, thalami, medial temporal lobes, left cerebral peduncle, medial cerebellar hemispheres as well as pons. The lesions involving the globus pallidus, left cerebral peduncle, and pons have become less conspicuous. The remaining lesions appear stable. There is no abnormal parenchymal enhancement. Incidental tentorial deficiency.The ventricles and sulci retain normal size configuration. There is no abnormal fluid collection. There is no midline shift or basal cistern effacement. The paranasal sinuses and mastoid air cells are clear. Expected vascular flow voids are demonstrated.The optic nerves, chiasm, and tracts appear normal. There is no optic nerve sheath dilatation. The extraocular muscles are normal and symmetric with physiologic, homogeneous, and intense contrast enhancement. The globes appear normal with physiologic enhancement of the ciliary bodies and choroid. No retinal detachment or vitreous clouding. The lacrimal glands are symmetric and within normal limits for size. No orbital mass lesion.
1.Stable size of diffuse plexiform neurofibroma involving right frontotemporal scalp and right cheek as well as the right temporalis muscle. 2.No orbital mass or evidence of abnormal orbital signal/enhancement.3.Redemonstrated are ill-defined areas of FLAIR hyperintensity in the globus pallidus, thalami, medial temporal lobes, left cerebral peduncle, medial cerebellar hemispheres as well as pons. The lesions involving the globus pallidus, left cerebral peduncle, and pons have become less conspicuous. 