Leiomyosarcoma in the Nasopharynx: MR Imaging Findings

MR images of a 23-year-old man with a mass in the nasopharynx.

A, Sagittal gadolinium-enhanced fat-suppressed T1-weighted MR image reveals a well-demarcated tumor arising from the posterior wall of nasopharynx (arrow) with downward extension to oropharynx and compressing the soft palate and uvula (arrowhead).

B, Coronal gadolinium-enhanced fat-suppressed T1-weighted MR image shows that the tumor is confined within the nasopharynx and oropharynx without involvement of sphenopalatine foramen and pterygopalatine fossa on either side.

C, Axial T1-weighted image shows intermediate signal intensity of the tumor with lateral displacement of adjacent longus capitis muscles bilaterally (arrows).

D, Axial T2-STIR image at the same level as in C shows high signal intensity of the tumor. An enlarged 1-cm lymph node is seen in the right lateral retropharyngeal space (arrow).

E, Axial gadolinium-enhanced fat-suppressed T1-weighted MR image at the same level as in C shows strong homogenous enhancement of the tumor.

F, Axial gadolinium-enhanced fat-suppressed T1-weighted MR image shows a normal mucosal pattern of the bilateral lateral pharyngeal recesses (arrows) without tumor involvement.