My 2nd Cancer Diagnosis

EXAM:  CT SOFT TISSUE OF NECK W CONTRAST

EXAM DATE AND TIME:  6/3/2022 12:00 PM

HISTORY: Neck mass.  History of oropharyngeal cancer.

COMPARISON:  Correlation is made to PET/CT dated December 30, 2019.

TECHNIQUE: CT scan of the neck was performed. 75 mL of Isovue-370 IV contrast were administered. Coronal and sagittal reformats were provided.

FINDINGS:

Surgical clips are noted in the right level 2 region, from prior lymph node resection.  There is lobular enhancing mass surrounding the surgical clips and extending to the right parapharyngeal fat.  The mass abuts the posterior margin of the right submandibular gland and the medial margin of the right parotid tail.  It measures 2.2 x 1.8 x 2.7 cm.  The right internal jugular vein traverses through the posterior aspect of the mass and is likely severely narrowed or invaded.  There is also possible obliteration of the right external carotid artery.

Resection of the right palatine tonsils is noted.

The nasopharynx, oropharynx, hypopharynx, glottic, and subglottic airway are patent.

The major salivary glands are grossly unremarkable.  The thyroid is small and homogeneous.

The lung apices demonstrate no focal infiltrate or nodule. The osseous structures demonstrate no suspicious lytic or blastic lesions.  There are degenerative changes in the cervical spine.

IMPRESSION:

1.  Ill-defined enhancing mass in the right level 2 region, surrounding the surgical clips and extending to the right parapharyngeal space, suspicious for recurrent tumor or adenopathy.  There is severe stenosis or possible invasion of the right internal jugular vein and right external carotid artery.

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