49-year-old female presents for routine follow-up of prior parotid cancer status post resection. MRI Brain:No abnormal parenchymal or meningeal enhancement is identified. There is no evidence mass or edema. Again demonstrated are numerous foci of punctate susceptibility artifact predominantly within the right temporal lobe, brainstem, and cerebellum, which are compatible with tiny microhemorrhages and presumably sequela from prior radiation therapy. The ventricles and basal cisterns are normal in size and configuration. No evidence of infarct. The expected intracranial vascular flow voids are present. Stable partial opacification of the right mastoid air cells. The orbits are unremarkable.MRI ST Neck:Posttreatment changes in the neck including resection of the right parotid gland as well as atrophy of the right submandibular gland. Stable appearance of the tongue with volume loss of the right hemitongue and posterior ptosis of the left tongue base. No enhancing soft tissue mass to indicate a recurrence. There are scattered subcentimeter neck lymph nodes which are not pathologically enlarged. No significant lymphadenopathy. The thyroid, left parotid, and left submandibular glands are unremarkable. The cervical spine demonstrates mild multilevel degenerative changes without suspicious osseous lesions.
1. No evidence of metastatic disease in the brain.2. Stable posttreatment changes in the neck related to prior right parotid tumor without evidence of locoregional tumor recurrence.3. Multiple tiny foci of susceptibility in the brain are again seen and may represent tiny cavernous malformations related to prior radiation therapy.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.