Huge right sided nasopharyngeal mass with bulk dimensions of 5.6 x 4.3 cm which extends cranially to invade the right side of the cavernous sinus surrounding the C4 segment of the ICA. The tumour extends into the right carotid space with tumour circumferentially around the right internal carotid artery and posterior extension towards the right hypoglossal canal.
Tumour extends laterally to infiltrate into the right medial pterygoid muscle and posteriorly into the right longus capitis muscle in the prevertebral space. Laterally the tumour infiltrates and expands the right buccinator space.
Signal change in the right side of the clivus suggests marrow infiltration.
Fluid in the mastoids and maxillary sinuses, the former in keeping with Eustachian tube obstruction.
Large volume cervical lymphadenopathy with a 6.1 cm right submandibular and bilateral internal jugular chain nodes (levels II and III) upto 3.5 cm.