Embryonal rhabdomyosarcoma

There is a large, heterogeneously enhancing mass which appears to be centered in the right masticator space. The mass extends anteriorly to the posterior wall the right maxillary sinus. The mass extends posteriorly to the retropharyngeal region and abuts the right longus coli muscle, but does not extend into the cervical spine. There is extension cephalad with enhancement in the right foramen ovale within a portion of the right middle cranial fossa. There is extension into the cavernous sinus, the region of the right eustachian tube, and in the right glenoid fossa/right temporomandibular joint region.

The mass extends posterolaterally into the superficial lobe of the right parotid. There is widening of the right pterygopalatine fossa and sphenopalatine foramen. The mass extends medially to cause mass effect on the right tonsillar pillar, without airway compromise.

There is a large, T2/FLAIR hyperintense, mass with irregular contrast enhancement in the superior right neck. The margins of this tumor include posterior wall of right maxillary sinus, undersurface of right zygomatic arch, nasopharyngeal soft tissues, and the longus collie muscles. It extends to the midline within the nasopharynx and compresses the fossa of Rosenmuller. The eustachian tube is blocked and there is extensive fluid within the right mastoid air cell complex. Superiorly, the tumor extends through the foramen ovale and abuts the undersurface of the mesial right temporal lobe. Inferiorly, the tumor is separated from the submandibular gland by the depressed lateral pterygoid muscle.

The right common carotid artery and internal jugular vein are displaced posteriorly but appear patent.