Recurrent nasopharyngeal carcinoma (NPC) in the cerebellopontine angle (CPA). A homogeneously enhanced lesion with clear demarcation in the right CPA (arrows in a: T2-weighted magnetic resonance (MR) image and arrows in b: contrast-enhanced MR) was found (patient 25) 4 years after irradiation for NPC. Enlargement of the right internal meatus (arrow head in a: T2-weighted MR image) was also demonstrated. The lesion (arrows in c: 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET)) and the neck lymph node had increased uptake of 18F-FDG. Postoperative histological examination revealed an undifferentiated non-keratinizing carcinoma immunopositive for CK and P63 and positive for Epstein-Barr virus-encoded RNA in situ hybridization (EBERs ISH) (arrows in d: positive EBERs ISH in tumor cell nuclei, ×100).