Large well defined enhancing mass centred on the left fossa of Rosenmuller with bulk dimensions of 5.4 x 4.4 cm. The mass extends inferiorly to the oropharynx and superiorly into and almost completely filling the sphenoid sinus. On the left the tumour involves the posterior nasal canal.
The mass crosses right of the midline at the level of the nasopharynx and on the left abuts 180 degrees of the internal carotid artery.
A 8mm tongue of tissue extends into and widens the left sphenopalatine foramen and pterygopalatine fossa into the pterygomaxillary tissue.
Pituitary fossa and floor of the anterior cranial fossa are intact. The left medial pterygoid plate and posterior aspect of the bone nasal septum is irregular with cortical disruption.
Obstructive fluid in the left maxillary sinus. Obstructive fluid in the left mastoid due to Eustachian tube obstruction from the mass.
Malignant 4.9 cm left level V nodes with some smaller adjacent sub-centimetre nodes.
Left level III nodes up to 15 mm. Left 1B up to 13 mm.