Oropharyngeal squamous cell carcinoma

Large mass involving the posterior wall of the oropharynx (3.3 x 2.0 cm axial, crossing midline). Superior extension into the lower nasopharynx just above the level of the palate, and inferiorly to the level of valleculae. Contiguous soft tissue thickening extends across the right tonsillar fossa into right. Posteriorly it extends into the prevertebral space, likely involving the longus colli. No vertebral cortical breach seen.

Symmetrical thickening of the aryepiglottic folds is suspicious for tumor involvement requiring direct visualization.

Bilateral level 2a lymphadenopathy.

Large mass in the posterior wall of the oropharynx extending across the midline (7.2 x 2.0 x 3.2 cm). Low T1W, intermediate T2W signal with homogeneous enhancement.

Superiorly it extends to the level of the hard palate, displacing the soft palate anteriorly which does not appear 

Inferior extension to the level of vallecula.

Lateral extension to involve the right palatine fossa and the lateral aspect of the right vallecula.

There is involvement of the posterior wall of the hypopharynx. The aryepiglottic folds appear thickened, particularly on the right.

Posteriorly the tumor extends into the prevertebral space and involve the longus colli, abutting the C1 body with signal change in the anterior arch.

There is no vertebral body enhancement.

Lingual tonsillar enlargement.

Bilateral levels 1b and 2a lymph node enlargement.

Prominent lymph nodes along bilateral levels 3 and 4 and in the retropharyngeal regio, measuring up to 10 mm on the left.