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Click 46 year old known colon cancer female patient with perineural tumour spread along maxillary(V2) branch of the left trigeminal nerve, intracranial extension and involvement of the trigeminal ganglion.
MRI axial T2-weighted sequence demonstrates abnormal diffuse T2 high signal intensity and in the left levator veli palatini muscle and pterygoid muscles with normal muscle volume, signifying subacute denervation changes. Also left mastoid air cells show T2 hyper intense fluid signal suggestive of mastoiditis due to secondary Eustachian tube dysfunction.

Click 46 year old known colon cancer female patient with perineural tumour spread along maxillary(V2) branch of the left trigeminal nerve, intracranial extension and involvement of the trigeminal ganglion.
MRI axial T1-weighted post I.V. administration of contrast medium (gadolinium; gadopentate dimeglamine chelate) sequence demonstrates abnormal diffuse contrast enhancement in the left levator veli palatini muscle and pterygoid muscles, in keeping with subacute denrvation changes.

Click 46 year old known colon cancer female patient with perineural tumour spread along maxillary(V2) branch of the left trigeminal nerve, intracranial extension and involvement of the trigeminal ganglion.
MRI Coronal 3D T2 weighted CISS sequence shows abnormal soft tissue replacing the marrow of the pterygoid body and floor of sphenoid sinus on the left side, indicating skull base metastases, with infiltration of vidian nerve canal, foramen rotundum and pterygopalatine fossa. More posterior section shows abnormal soft tissue thickening of V3 branch of the trigeminal nerve, with extension into the left foramen ovale and the Meckel`s cave. Findings are suggestive of perineural tumour spread along V2 and V3 branches of the trigeminal nerve.

Click 46 year old known colon cancer female patient with perineural tumour spread along maxillary(V2) branch of the left trigeminal nerve, intracranial extension and involvement of the trigeminal ganglion.
MRI high resolution axial 3D T2 weighted (CISS) sequence at the level of the skull base shows abnormal soft tissue in the region of the left foramen rotundum and left foramen ovale suggestive of perineural tumour spread along V2 and V3 branches of the trigeminal nerve, with extension into the middle cranial fossa and Meckel`s cave, shown as replacement of normal Meckelís cave CSF hyperintense signal with abnormal hypointense soft tissue.

Click 46 year old known colon cancer female patient with perineural tumour spread along maxillary(V2) branch of the left trigeminal nerve, intracranial extension and involvement of the trigeminal ganglion.
Reconstructed coronal 3D FLASH T1-weighted image post I.V. administration of Contrast medium cm (gadolinium; gadopentate dimeglamine chelate) at the level of the pterygopalatine fossa, show abnormal enhancing soft tissue replacing the marrow of the pterygoid body and the floor of sphenoid sinus on the left side, indicating skull base metastases, with infiltration of the vidian nerve canal, foramen rotundum and the pterygopalatine fossa. More posterior section shows extension of the abnormal enhancing soft tissue along the left foramen ovale which is widened, and in the Meckel`s cave.

Click 46 year old known colon cancer female patient with perineural tumour spread along maxillary(V2) branch of the left trigeminal nerve, intracranial extension and involvement of the trigeminal ganglion.
MRI high resolution axial 3D T1 weighted (FLASH) sequence post I.V. administration of contrast medium (gadolinium; gadopentate dimeglamine chelate) at the level of the skull base shows abnormal enhancing soft tissue in the region of the left foramen rotundum and left foramen ovale suggestive of perineural tumour spread along V2 and V3 branches of the trigeminal nerve, with extension into the middle cranial fossa and Meckel`s cave, shown as replacement of normal Meckelís cave CSF signal and abnormal contrast enhancement.