T4N3 nasopharyngeal cancer, s/p induction chemotherapy followed by chemoradiation, now with locally advanced recurrence with involvement of the brain (right temporal lobe), cavernous sinus, and Meckel's cave, currently receiving induction chemotherapy with carboplatin/taxol. There is marked interval decrease in size of the mass within the right cavernous sinus and the adjacent right middle cranial fossa, measuring up to 25 mm in length and 20 mm in thickness. There is mild intrinsic T1 hyperintensity and T2 hypointensity in the tumor related to treatment effects. There is no appreciable edema in the adjacent right temporal lobe. There is no discernible tumor in the right lateral nasopharyngeal recess. There is no evidence of acute cerebral infarction. The ventricular system is not enlarged. There is mild scattered paranasal sinus mucosal thickening. The orbits are unremarkable.
Marked interval decrease in size of the recurrent tumor involving the right cavernous sinus and adjacent middle cranial fossa with superimposed treatment effects.