ke/sb/rg.
Date : 00.00.00

Name of the Patient : Abc XyzD. Talmn / M / 36 yrs.
Referred by : Dr. Abc Xyzah.
Examination : M.R.I. of the Brain.

CLINICAL PROFILE :

H/O fall 8 years back with injury to the back. Operated for the same.
C/O gradual progressive weakness of BLE and BUE, slurred speech and diminished vision since then.

EXAMINATION :

M.R.I of the brain was performed using the following parameters :

5 mm thick T1 Weighted, proton and T2 Weighted axial images.

5 mm thick FLAIR coronal images.

3 mm thick T2 Weighted coronal images.

OBSERVATION :

There is a large, well-defined mass lesion in the right parapharyngeal space which measures approximately 3.8 x 4.5 x 3.1 cms. There is indentation upon the right lateral aspect of the oropharynx. This lesion shows an intermediate signal intensity on the T1 Weighted images and is seen to turn hyperintense on the T2 Weighted and FLAIR images at the periphery with the centre turning hypointense. Few septae are noted within this lesion.

There is no focal area of altered signal intensity within the brain parenchyma.

Both the lateral, third and the fourth ventricles are normal. The basal cisternal spaces are unremarkable. There is no shift of the midline structures. No obvious vascular anomaly is identified on this study.
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IMPRESSION :

The MRI features are suggestive of a large, well-defined mass lesion in the right parapharyngeal space measuring approximately 3.8 x 4.5 x 3.1 cms as described.

The possibilities to be considered are,

1. Mixed tumor of the salivary rest cells in the parapharyngeal space.

2. Nerve sheath tumor.