Presentation
Nasal obstruction and left-sided neck mass.
Patient Data
There is a 25 x 30 mm abnormal signal intensity ( low on T1 and intermediate on T2) mass lesion involving the nasopharyngeal mucosa centered on the right fossa of Rosenmuller with a midline cross to the left side with post-contrast enhancement.
The described mass has the following extensions:
anteriorly: extending to the posterior choanal orifice of the nasal cavity and infiltrating the right medial pterygoid plate
posteriorly: the lesion is abutting the prevertebral muscle with no MRI evidence of extension
laterally: the lesion involving the levator palatini muscle and pharyngo-basilar fascia
superiorly: no MRI evidence of intracranial extension
inferiorly it is extending to the upper oropharyngeal mucosa
posterolaterally the lesion involving the petrous apex abutting the medial aspect of the internal carotid artery. secondary right mastoiditis is also noted
Bilateral enlarged upper cervical lymph nodes (bilateral level I and II) and huge lymphadenopathy along with left sided posterior cervical space measuring about 40 x 65 mm with heterogeneous enhancement after contrast injection due to metastasis.
Case Discussion
Imaging findings are consistent with nasopharyngeal carcinoma with metastatic upper cervical chain LAPes and a huge one at the left-sided posterior cervical space. The biopsy of this case showed undifferentiated nonkeratinizing nasopharyngeal carcinoma. MRI staging is T3 N3 Mx.
Unable to process the form. Check for errors and try again.