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A 28 mm x 22.5 mm x 40 mm heterogenously enhancing mass lesion involving the deep lobe of the left parotid is demonstrated. The lesion demonstrates areas of high signal on T2WI and marked restricted diffusion. Although the mass lesion contacts the left mandibular angle, the mandibular cortex and marrow signal is preserved.
There is no abnormal perineural enhancement. Moderately enlarged left-sided level II lymph nodes noted as well as a left retro-pharyngeal lymph node, measuring up to 6.5 mm. Minimally enlarged right-sided level II lymph nodes noted, likely inflammatory.
There is a right rim-enhancing, cyst-like lesion with internally restricting content within the right glosso-tonsillar sulcus, possibly representing a retention cyst.
Intracranially, there is an established (likely previously haemorrhagic) infarct within the left external capsule. The well-rounded cyst-like lesion closely associated with the right anterior commissure, likely representing a prominent perivascular space or an established lacunar infarct.
The heterogenous mass lesion within the deep lobe of left parotid likely represents a malignant lesion.
There is no associated peri-neural tumour spread, however, the ipsilateral level II lymph nodes are enlarged.