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Contrast CTB show heterogenous soft tissue mass within left posterior mastoid and petrous apex with cortical breach into left supratemporal masticator space, left sigmoid sinus and middle ear.
The soft tissue mass extends superficially to the posterosuperior temporal fossa adjacent to base of pinna and along cartilaginous left external auditory canal.
There is erosion of auditory ossicles and retraction of tympanic membrane. There also likely erosion of the otic capsule adjacent to the lateral aspect of the lateral semicircular canal. The carotid canal is not involved.