Presentation
Right-sided hearing loss in a patient operated on 11 months prior for carcinoma of the right parotid gland.
Patient Data
right-sided parotidectomy
abnormal enhancement on the course of the 7th nerve from stylomastoid foramen up to the level of the geniculate ganglion and IAC
an 8 x 10 x 15 mm significantly enhances mass along the acousticofacial bundle on the right side
high signal foci in T2 and flair sequences at sub cortical and periventricular white matter of both cerebral hemispheres depict microvascular ischemic events
Case Discussion
MRI findings are most consistent with widespread perineural tumor spread in a patient who underwent surgery for adenoid cystic carcinoma of the right parotid gland. Perineural tumor spread occurs when cancer cells extend along nerve sheaths, commonly from head and neck malignancies. The MRI signs of perineural tumor spread include nerve thickening, neural foramen widening, loss of surrounding fat, and abnormal contrast enhancement.
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