Acinic cell parotid cancer now with headache and nausea, evaluate for progression of skull base metastases. There are postsurgical findings related to prior right lateral temporal bone resection and parotidectomy. There is marrow replacement with corresponding patchy heterogeneous enhancement involving the right basiocciput, petrous ridge, condylar and squamous portions of the occipital bone, and the right lateral mass of C1, with a small soft tissue component in the upper carotid space, all appearing similar to prior examinations. There are no new skull base osseous lesions identified. Intracranially, no new or suspicious lesions are seen. There are a few unchanged punctate foci of enhancement within the right lateral cerebellum, immediately adjacent to the abnormal skull base, with surrounding T2 hyperintensity. Supratentorially, there are several scattered foci of nonspecific T2 hyperintensity, which appear unchanged. There are no new enhancing intracranial lesions. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles remain normal in size and morphology.
Findings related to right lateral temporal bone resection and parotidectomy without significant change in the treated right skull base and right craniocervical junction tumor, as well as the abnormality in the right cerebellar hemisphere.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.