Figure 3

Extensive nasopharyngeal cancer with skull base destruction and perineural spread into the brainstem. (T4). A, B: coronal and axial post-contrast T1-weighted MR image with fat suppression. A image shows tumor extension from the nasopharynx through the right wide foramen ovale and perineural spread along the V/3 (long arrow) into the cavernous sinus (CaS, arrow-head). The CaS is flared out towards the Meckel’s cavity and tumorous enlargement of the trigeminal ganglion (semilunar, or Gasser) can be well seen (on B, C images, short arrows). C: axial T2-weighted image shows signal intensity changes in the pons secondary to the perineural tumour spread along trigeminal nerve root (on B, C images, long arrows) D: axial nonenhanced CT scans show tumorous bone destruction of the clivus on the right side (long arrow).