FIGURE 13.

The right nasopharyngeal squamous cell carcinoma (T) in a patient with bilateral cervical adenopathy, right ptosis, and infraorbital skin paresthesia. Coronal contrast-enhanced T1-weighted fat saturated (A, B, E), coronal short-TI inversion recovery (C), axial T1 (D), and axial dynamic contrast-enhanced (F) images. There is tumor extension in the right masticator space (M) in the mandibular nerve distribution area, thus tumor cells spread retrograde to the foramen ovale (CN V3) which is enlarged (white arrow). Afterward, the neoplastic extension affects Meckel’s cave (dashed arrow) and cavernous sinus (+), with enlargement and CE. Notice the CSF signal in the normal left Meckel’s cave (black arrow) and it’s effacement on the right. Obliteration of the fat in the right PPF indicates CN V2 involvement (arrowhead). From here, there is anterograde PNS to the infraorbital nerve (double arrow). The right CN II invasion is also detected (gray arrow).