Diagnosis: Malignant neoplasm of brain, unspecifiedClinical question: Metastatic urothelial cancer with brain meets, s/p resectionSigns and Symptoms: intermittent HA There is redemonstration of status post left frontal craniotomy. Since the prior exam a hemorrhagic lesion in left frontal lobe has regressed. There is significantly less perilesional signal change compared to the prior exam and less mass effect. There is some nodular enhancement present along the anterior and inferior aspect of the surgical bed. There is some susceptibility effect along the inferior aspect of the lesion.There is a 10 mm enhancing lesion in the left temporal lobe at the superior temporal gyrus adjacent to the superior temporal sulcus which previously measured 7 mm.The visualized portions of the paranasal sinuses demonstrate minor opacities. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Since the previous exam the left temporal lobe mass has increased in size. This is compatible with metastatic disease.2.The patient status post left frontal craniotomy. Vasogenic edema associated with a left frontal lobe resection site for mass has regressed. The possibility of some residual or recurrent tumor cannot be excluded.