MRI of nasopharyngeal carcinoma metastatic to the cerebellopontine angle.

In patients with nasopharyngeal carcinoma, intracranial spread may occur via direct extension from the base of the skull or via perineural spread. Perineural spread usually affects branches of the trigeminal nerve. We describe two patients with recurrent nasopharyngeal carcinoma, who presented with a solitary mass in the cerebellopontine angle without associated bony destruction. MRI findings mimicked those of acoustic schwannoma. The imaging findings and possible pathways of spread are discussed.