Squamous cell carcinoma of the face, status post prior treatment. There are postoperative findings related to partial resection of the right nasal ala. There is an infiltrative mass along the medial right cheek and remaining portions of the right nasal ala, which measures up to approximately 5 cm. There is perineural extension of tumor along the infraorbital nerve, with widespread infiltration of the posterior orbit, and into the pterygopalatine fossa and superior orbital fissure, from which it attains the right cavernous sinus and Meckel cave. The contiguous portion of the right trigeminal nerve trunk is also involved by tumor, with associated denervation changes in the right masticator muscles. There is no significant cervical lymphadenopathy. The thyroid and salivary glands are unremarkable. There is no evidence of acute infarct. The brain parenchyma appears unremarkable. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. There is fluid within the bilateral mastoid air cells. There are bilateral lens implants.
1. An infiltrative mass along the medial right cheek and remaining portions of the right nasal ala, which measures up to approximately 5 cm is compatible with recurrent tumor, perhaps with superimposed cellulitis. 2. Extensive perineural extension of tumor along the infraorbital nerve, with widespread infiltration of the posterior orbit, and into the pterygopalatine fossa and superior orbital fissure, from which it attains the right cavernous sinus and Meckel cave. The contiguous portion of the right trigeminal nerve trunk is also involved by tumor, with associated denervation changes in the right masticator muscles.3. No evidence of cervical lymph node or brain parenchymal metastases.