28-year-old female with history of recent nasopharyngeal cancer status post chemo/RT. Please eval extent of disease. CT of soft tissues of the neck with infusion.Images through the skull base demonstrates a slight prominence of the left cavernous sinus compared to the right and also there are sclerotic changes of the sphenoid bone on the left side. Subtle erosive changes of the pterygoid bone on the left, specifically the medial leaf of the pterygoid bone is noted. combination of the above findings are highly suspected of possible extension of tumor into the skull base and the left cavernous sinus. These findings were present on the prior study. Further evaluation with an MRI examination is recommended.Chronic inflammatory sinus disease of the sphenoid sinus is also present which was also noted on the prior exam and demonstrates no interval change. There is complete opacification of bilateral mastoid air cells and middle ear cavities. These findings on the left were present on the prior study however the findings on the right are new since prior exam.In comparison to prior exam there is significant interval reduction in the size of previously noted left high nasopharyngeal tumor. On the current exam some subtle soft tissue swelling with edematous changes and without definitive enhancement is still is present. This finding extends anteriorly into the posterior choana of the left nasal cavity.No evidence of any pathologic adenopathy neck is detected.Limited images of the apices of the lungs are unremarkable. No additional areas of bony erosion or metastatic lesions is detected.CT of brain with infusion.No evidence of metastatic lesion of the brain parenchyma or the meninges is detected. The bony density of calvarium is unremarkable with the exception of findings described on the left side of the sphenoid bone/pterygoid adjacent to the patient's known tumor.
1.Significant reduction in the size of patient's known high left nasopharyngeal cancer with no definite measurable tumor on the current study.2.Erosive and sclerotic changes of the skull base involving the left pterygoid bone and left aspect of the body of sphenoid bone as detailed.3.The bony changes as well is a slight prominence of the cavernous sinus on the left raises the possibility of extension of tumor into the skull base and cavernous sinus. Further follow-up with an MRI is recommended.