After radiation and chemotherapy.

Poorly Defined Squamous Cell Carcinoma, Nasopharynx, with Perineural Tumor Spread and Recurrence

Findings:

Multiple MR images demonstrate a poorly defined enhancing mass within the anterior sphenoid region, with associated enhancing tissue of similar characteristics involving the right cavernous sinus and foramen ovale region. Widening of right foramen ovale is best seen on coronal images.

On the follow-up CT images after radiation and chemotherapy, the right cavernous sinus mass has resolved, but the anterior sphenoid mass is progressive and there is now infiltrative mass in the right nasopharyngeal masticator space invading the right maxillary sinus and destroying the posterior wall of the right maxillary sinus. Precise interface between inflammatory mucosal thickening and mass is not well differentiated in the nasal cavity. There is also prepontine extent of the mass through the clivus.

Discussion/Differential Diagnosis:

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