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FIG 5. Patient 6, a 49-year-old woman presenting with a mass on her left upper lip. Biopsy confirmed melanoma, and she was treated with surgery and radiation. A follow-up scan was performed in April 2002, 5 months after her initial surgery, and further follow-up was performed in October 2002.
A, Coronal T1-weighted image (600/11/2) demonstrates no abnormality of the infraorbital nerve.
B, In follow-up 6 months later, the patient noted left cheek numbness and tingling, and a repeat MR was performed. Coronal T1-weighted image (600/11/2) was initially interpreted as negative, but further review demonstrates enlargement of the left infraorbital nerve (arrow).
C, Coronal T2-weighted image (4000/102/2) demonstrating that the enlarged left infraorbital nerve is low in signal intensity and not consistent with benign sinus contents adjacent to the infraorbital canal.
D, Contrast-enhanced coronal T1-weighted image (600/11/2) with fat saturation demonstrating clear cut enlargement and enhancement of the left infraorbital nerve. The patient was taken to repeat resection, and perineural spread of malignant melanoma was confirmed.
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