History of right mandibular mass, s/p sclerotherapy 1/5/16Signs and Symptoms: Right mandibular mass Within the suprahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated. Within the infrahyoid neck on the basis of size criteria for lymphadenopathy no lymphadenopathy is appreciated.There is a mass centered in the right mandible associated with contrast enhancement and some mild enlargement. There is disruption of the cortex along the right anterior lateral aspect of the mass with some mild protrusion of the mass through this defect. Mass has predominantly high signal on T2 and low signal on T1 and is without diffusion restriction. Compared to the previous exam there are now patchy areas of nonenhancement and low T2 signal within the lesion which were not previously present suggesting some interval change with some fibrous tissue deposition.The visualized intracranial structures which include the posterior fossa are intact. There are patchy high signal foci on T2 imaging in the brainstem which are most likely vascular related. The visualized portions of the orbits and paranasal sinuses are intact. The paranasal sinuses and mastoid air cells are clear. There is a mild to moderate degree of periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images.The parotid and the submandibular glands appear intact.The carotid and vertebral vasculature visualized on this exam appears intact.The cervical vertebral bodies in general are intact with no evidence for canal stenosis. There are multilevel degenerative changes present in the cervical spine with reversal of the normal cervical curvature at C3-4, loss of disc space height, disc desiccation and endplate and uncovertebral osteophytes resulting in encroachment of right-sided exiting nerve roots at C6-7 and C5-6 and some narrowing of the spinal canal due to endplate osteophytes at C3-4, C4-5 and C5-6 . This is stable compared to prior exam.The eyeball lenses are thin.
1.Since the prior exam there is some retraction of a portion of the patient's right mandibular hemangioma indicating a partial response to treatment.2.Multilevel degenerative changes are present in the cervical spine.3.Periventricular and subcortical white matter lesions are nonspecific. At this age they are most likely vascular related. Similar-appearing lesions in the brainstem and thalami are also likely vascular related.