Male, 73 years old, history of metastatic melanoma with brain metastases, now with recent seizure and left-sided weakness. Assess for new brain metastases. Two new rim-enhancing lesions are evident within the right post-central gyrus, each containing blood fluid levels, measuring 13 and 10 mm in diameter. These lesions induce moderate local edema which tracks into the underlying white matter.A lesion within the left inferior parietal lobule has significantly increased in size now measuring up to 17 mm, previously 4 mm. A lesion along the left superior frontal sulcus has increased in size now measuring 7 mm, previously punctate. A new 10 mm lesion is evident within the paramedian right occipital lobe, and a new 16 mm lesion is evident more laterally in the right occipital lobe. The above lesions induce mild local edema. A 2 mm focus of enhancement is new within the left inferior frontal lobe.A lesion in the paramedian right parietal lobe is unchanged. The right frontal lobe resection cavity has collapsed with no significant change in the amount of enhancement and decreasing edema. The left superior frontal resection cavity is stable and free of enhancement.
Multiple new and/or growing lesions compatible with progression of metastatic disease.