Face:
Extracranial mandibular nerve: Mild increased signal diffusely.
Extracranial maxillary nerve: Mild increased signal and focal nodular thickening distal to the foramen rotundum
Inferior alveolar nerve: Nodular thickening of the right inferior alveolar nerve in the distal mandibular canal proximal to the mental foramen
Extracranial ophthalmic nerve: Normal
Facial nerves: Right- Mild diffuse increased signal and focal thickening of the nerve just proximal to the two major divisions in the periparotid area. Prominent zygomatic branches in the subcutaneous tissues adjacent to the nodular nodal lesions, involved. Mild increased signal on the left main facial nerve as well
Other lower cranial nerves: Normal
Lingual nerve: Normal.
Masses: Skin irregularity of the right periorbital anterior preseptal area with nodular soft tissue thickening extending along the medial wall of the zygomatic arch. The dominant nodular lesion measures 15 mm with ADC measuring 1.2 and appears adherent to the inferior aspect of the lacrimal gland. Another 8mm and 6 mm nodular lesions with peripheral irregularity under the skin with adjacent fascial thickening overlying the zygomatic arch- lymph node enlargements with local lymphangitis.
IMPRESSION:
Findings of recurrent disease of basal cell carcinoma in the periorbital and zygomatic area with likely perineural spread and lymphatic spread.
Multiple peripheral neuropathies as described. Imaging is limited due to lack of intravenous contrast.
NS-RADS: Nerve: N3 – Probably malignant neoplasia, Muscle: M0 – Normal
