Findings:
Imaged brain parenchyma is unremarkable. The orbits and mastoid air cells are clear. Mucosal thickening is seen in the maxillary sinuses bilaterally. The paranasal sinuses are otherwise clear.
An ill-defined mass lesion is identified in the right parotid gland, extended from the most posterior part of the retromandibular parotid to both superficial and deep lobes, measuring approximately 2.8 x 2.2 x 2.5 cm. It elicits heterogenous, predominantly low signal intensity on the T1w and T2w sequences.
The lesion overlays the ramus of mandibular and it infiltrates the superficial masseter and possibly the right styloglossus muscle on the right side. It encases the external carotid artery in its distal part.
A few small right level VIII lymph nodes are seen.
Multiple submandibular and cervical lymph nodes are noted bilaterally, measuring up to 1 cm in short axis.
The left parotid, submandibular and thyroid glands are unremarkable.
The tongue and the floor of the mouth have a normal appearance. The retromolar trigone is unremarkable.
The pharyngeal and glottic regions are normal. The parapharyngeal fat space is normal. The tonsils and adenoids are normal.
No bony abnormality is seen. The craniocervical junction and spinal canal appear patent.
Conclusion:
ILL defined mass lesion in the right parotid gland, involving both superficial and deep lobes and infiltrating the right superficial masseter and possibly the right styloglossus muscle, in keeping with malignant neoplasm. Suspicious small Level VIII lymph nodes on the right side.
No obvious bony erosion of the mandible.