Findings:
Unchanged to the previous study mild skin thickening and subcutaneous soft tissue thickening is seen surrounding the cartilaginous part of the external auditory canal and the pinna on the right side. No obvious bony erosions.
The flattened mass with superficial ulcer formation in the left frontolateral scalp is unchanged in size, measuring 3.3 x 0.7 cm and infiltrating the underlying temporalis muscle on the left.
Minimal cutaneous/subcutaneous soft tissue thickening is also noted in the left frontopolar region.
Mild involutional changes are seen in the brain parenchyma in the form of prominent cortical sulci and widened ventricles. No intra or extra-axial mass lesions or collections are identified. There is no mass or shift of midline.
Moderate background small vessel ischaemic disease is seen again. Lacunar defects are noted in the right internal capsule and thalamus. No focal or generalised oedema. No loss of the grey-white matter junction is seen.
Partially empty sella is seen.
A small, focal bony thinning of the right temporal bone is seen (SE 1, IM 9), compatible with a small temporal meningocele.
Bilateral IOL-implant is in situ. Partial obliteration of the mastoid air cells is seen on the right side.
The parotid and submandibular glands are unremarkable. There is no significant lymphadenopathy.
Moderate atherosclerotic changes are noted at bilateral carotid bifurcations.
The lung apices are clear.
Known, grade 1, degenerative anterolisthesis at C2/3 with kyphotic deformity of the cervical spine. Additionally, high-grade spondylodegenerative changes of the cervical spine are noted again. No suspicious bony lesions.
Conclusion:
Unchanged appearance of the residual/minimal soft tissue thickening along the cartilaginous part of the external auditory canal and the pinna on the right side, as well as unchanged ulcerating soft tissue lesion involving the left frontolateral scalp.
Minimal cutaneous/subcutaneous soft tissue thickening also in the left frontopolar region. Clinical correlation is advised.
No intracranial mass lesion, no bony destruction.