61-year-old male with history of left facial squamous cell cancer (likely cutaneous). Status post surgery and adjuvant RT. Please evaluate. Enhanced CT of soft tissues of neck:60 cc of Omnipaque 350 was administered for this exam.Axial 3 mm CT images of the soft tissues of the neck after administration of contrast are obtained. Coronal and sagittal 2-D reformatted images are also acquired.Diffusely irregular pattern of enhancement in the left parotid gland remains identical to prior study. Stranding of overlapping subcutaneous fat is also similar to prior study. The overall size and morphology of this abnormal parotid is identical to prior exam. These changes could represent residual tumor as well as post treatment changes. An MRI examination may be useful for further assessment of this changes.There is interval reduction in the degree of thickening and enhancement of the mucosal of the left lateral pharyngeal wall which extends to involve the left common base. These changes are likely secondary to post treatment. There is no evidence of pathologic lymphadenopathy.Enhanced head CT:This examination is essentially within normal limits and in particular no evidence of metastatic disease to brain parenchyma, that the meninges or the calvarium is detected.Calvarium, paranasal sinuses and mastoid air cells are unremarkable.
1.Stable appearance of irregularly enhancing left parotid gland in size, morphology and pattern of enhancement since prior study.2.Decrease in the degree of mucosal enhancement of the left lateral oropharyngeal wall and left basal scarring likely representing improved posttherapy changes.3.No evidence of pathologic lymph nodes.4.Negative enhanced head CT.