 Brain: There is continued interval decrease in size of the infiltrative enhancing mass centered within the nasopharynx and skull base, especially in the AP dimension. The tumor is ill-defined margins making distinct measurement difficult. As before, there remains nonspecific confluent enhancement extending laterally into the bilateral masticator spaces and pterygopalatine fossae as well as involving the clivus and sinonasal walls. There is persistent and unchanged involvement of the cavernous sinuses with encasement of the carotid arteries (however without evidence of luminal narrowing). There is no evidence of brain parenchymal involvement. A previously described left level 2A lymph node is only partially imaged, and better seen on the earlier neck CT, as is osseous involvement. Moderate to severe mucosal thickening is seen in the maxillary and ethmoid sinuses with near-complete opacification. Mild mucosalthickening is seen in the sphenoid sinuses. There is also complete opacification of the mastoid air cells and middle ears. Overall this represents increased opacification of the paranasal sinuses and mastoid air cells when compared with the prior MRI.There remains unchanged nonspecific patchy foci of T2 hyperintensity throughout the supratentorial white matter and pons most likely representing chronic small vessel disease. There is no evidence of acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids remain intact. Orbits: Intraorbital extension of the tumor has subsided bilaterally when compared to the presentation MRI, and unchanged when compared to the more recent MRI. Bilateral globes and intraconal contents including optic nerves are unremarkable.
Post-treatment findings with continued interval decrease in size of an infiltrative nasopharyngeal carcinoma with ill-defined margins making distinct measurement difficult.