Metastatic lung cancer, EGFR+, on Erlotinib and immunotherapy. There is no significant interval change in the enhancing lesion in the right cerebellar hemisphere that measures 3 x 3 mm in axial cross-section. There is a an unchanged enhancing extra-axial lesion along the left anterior clinoid process region. There is encephalomalacia within the left gyrus rectus associated with postoperative changes. There is a chronic lacunar infarct in the left basal ganglia with hemosiderin deposition. There are a few unchanged scattered nonspecific foci of T2 hyperintensity in the cerebral white matter. There is no evidence of acute intracranial hemorrhage or acute infarction. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits are grossly unremarkable. There is metal susceptibility effect in the left frontal calvarium.
1. Unchanged punctate metastasis in the right cerebellar hemisphere.2. Unchanged paraclinoid lesion may represent a meningioma.3. Encephalomalacia in the left gyrus rectus related to prior surgery.4. Chronic lacunar infarct in the left basal ganglia and a background of probable mild white matter chronic small vessel ischemic disease.