A moderate size lobulated mass is seen centred in the right ethmoid air cells, with intracranial extension through the right cribriform plate and extension into the right orbit. Overall dimensions are 3.7 centimetres SI, 1.8 centimetres transverse and 4.2 centimetres AP. The intracranial component is small with nodular indentation of the right gyrus rectus. Prominent flow voids are seen around this component. Linear dural enhancement seen along the planum sphenoidale and along the lateral floor of the right anterior fossa. The intraorbital component demonstrates lobulated compression of the medial rectus muscle with some linear extension to around the superior oblique muscle. No intraconal extension is identified. High resolution CT scan is recommended to assess the osseous integrity of the medial wall of the right orbit.
Inferior extension involves the middle turbinate muscle. Posterior extension is to the region of the sphenoethmoidal recess and there is lobulated mucosal thickening seen posterior to this within the right sphenoid sinus. There is lobulated mucosal thickening within the right maxillary antrum.
A T2 hyperintense cystic structure is seen superior to the hyoid bone in the root of the tongue measuring 5 x 8 x 7 mm. This likely represents a developmental lesion such as a thyroglossal duct cyst.
Scattered enlarged upper cervical lymph nodes are identified- largest in level 2 bilaterally. Bilateral enlarged retropharyngeal lymph nodes.
Conclusion: Findings compatible with a right-sided esthesioneuroblastoma with a small intra cranial component and extension into the right orbit.