Patient with history of squamous cell carcinoma of ethmoid sinus with recurrence.Please evaluate for disease. Metastases. CT of soft tissues of the neck.Images through the skull base and including cavernous sinuses remain within normal limits.Revisualization of extensive opacification of left ethmoid air cells which also demonstrated a small bony defect along its anterior aspect. In comparison with the prior examination there is evidence of reduction in the amount of soft tissue density that was immediately anterior to the bony defect of the lamina procedure and anterior aspect of the floor of the orbit on the left. This may be result of interval improvement of post therapy changes. Two entirely exclude possibility of residual tumor MRI examination in this case would be most helpful.The bony density of the area of the exam demonstrates no evidence of any new area of bony erosion. Images through the rest of the soft tissues of the neck demonstrate a few small nonpathologic lymph nodes which are stable since prior study. No pathologically enlarged lymph node is detected.Limited images through the apices of the lungs demonstrate extensive findings of multiple pulmonary emphysematous bulla (right greater than left. No definitive metastases is detected.CT of brain with infusion.Notice of metastatic disease to the brain, calvarial or leptomeninges is detected. This is study is essentially within normal limits.75 cc of Omnipaque was utilized for these studies.
1.Negative CT of brain with infusion.2.Reduction in the amount of soft tissue density at the level of the left ethmoid air cells and left orbit since prior study. Further evaluation to exclude residual tumor with an MRI is recommended.3.No areas of pathologic adenopathy in the neck and stable multiple small bilateral lymph nodes.