 Interval enlargement of polypoid right nasal cavity mass is seen which appears to infiltrate the right inferior nasal turbinate. The mass is difficult to demarcate from the residual normal right inferior turbinate and measures approximately 6.1 cm in the AP dimension, previously approximately 5.4 cm. There is interval increase in extension into the right maxillary sinus with the mass measuring approximately 2.8 cm in the transverse dimension, previously remeasured as 2.2 cm. In the craniocaudal dimension, mass measures approximately 3.3 cm, previously 2.6 cm.There appears to be associated obstruction of the inferior portion of the right nasolacrimal duct with distention of the upper right nasolacrimal duct and sac.In the left orbit, there is an ovoid intraconal mass which involves the left lateral rectus muscle, measuring 1.4 x 2.7 cm in the axial plane and 1.7 cm in the craniocaudal dimension. The left lateral rectus muscle is suspected to be inferiorly displaced although muscle infiltration is not excluded. In retrospect a small lesion in this region can be appreciated on prior MRI where it measures 6 x 12 x 9 mm, measured in a similar plane. There is medial deviation of the left optic nerve without signal abnormality in the optic nerve. Nonspecific subcentimeter cervical lymph nodes are present and can be better imaged with dedicated neck CT or MRI.Partially imaged brain demonstrates no intracranial mass or mass effect or abnormal enhancement to suggest metastasis.
1. Interval enlargement of right nasal cavity mass which appears to infiltrate the right inferior turbinate and erodes into the right maxillary sinus measuring approximately 6.1 x 2.8 x 3.3 cm, previously 5.4 x 2.2 x 2.6 cm. Findings consistent with tumor progression. 2. Left intraorbital mass is also larger measuring 1.4 x 2.7 x 1.7 cm, previously 0.6 x 1.2 x 0.9 cm, and highly suspicious for enlarging metastasis.