Female, 45 years old, with history of adenoid cystic carcinoma. Brain:No evidence of parenchymal edema or mass effect is seen. Diffusion-weighted images are normal. No pathologic parenchymal or extra-axial enhancement is seen. An incidental small developmental venous anomaly is seen within the left frontal lobe.Some residual pathologic soft tissue thickening and enhancement does remain evident within the left pterygopalatine fossa, foramen ovale, foramen rotundum, and to a mild degree in the left cavernous sinus. This soft tissue process has, however, improved when compared to the prior neck MRI. The left parotid gland is smaller than the right which is a stable finding.Although this examination is not tailored for the assessment of the pituitary gland, the right aspect of the gland does remain larger and hypoenhancing relative to the left, a stable finding.No evidence of significant intracranial hemorrhage or any abnormal extra-axial fluid collection is seen. The ventricles are normal in size and morphology. A small pineal cyst is noted incidentally.C-spine:Alignment is anatomic. Vertebral body height and morphology are normal. No concerning marrow replacement, edema or pathologic marrow enhancement is seen.The visualized spinal cord is normal in signal intensity and morphology. No pathologic intramedullary or leptomeningeal enhancement is seen.Minimal disc degeneration is seen at C5-6 with a small annular fissure but no significant disc bulging or herniation. At no level is there any spinal canal or neuroforaminal stenosis.The paraspinal soft tissues are unremarkable.
1.No evidence of brain parenchymal metastatic disease.2.Interval improvement in the appearance of perineural disease spread involving the pterygopalatine fossa, foramina ovale and rotundum, and the left cavernous sinus. 3.Redemonstration of a lesion in the right aspect of the pituitary gland.4.No significant abnormalities in the cervical spine.