History of breast cancer. Headache status post tumor resection. There are postoperative changes related to bilateral frontal craniotomy for resection of a lesion in the cingulate gyrus in the right posterior frontal lobe. There is resection of much of the solid component medially with residual lobular enhancement at the anterior, lateral and posterior margin of the resection cavity. There is slightly increased surrounding vasogenic edema. The tumor minimally extends across the midline and likely through the falx to the left. There is redemonstration of additional supratentorial and infratentorial enhancing lesions consistent with metastatic lesions. There is a second superficially located left frontal metastatic tumor with enhancement measuring approximately 11 mm, previously 12 mm, with minimal surrounding edema and regional mass effect. A third smaller metastatic lesion abutting the right falx in the left posterior parietal region measures 8 mm, previously 9 mm, with mild surrounding edema and mild mass effect.There is a parenchymal metastatic lesion in the right posterior cerebellum measuring 10 mm, previously 10 mm, without surrounding edema or appreciable mass effect. Ventricular system is within normal limits and without midline shift. The signal void of major intracranial arterial branches are identified. Calvarium is unremarkable without detectable abnormal enhancement. Paranasal sinuses demonstrate a small retention cyst in the dependent portion of right maxillary sinus and unremarkable otherwise.
Postoperative findings related to subtotal resection of a right posterior frontal cingulate gyrus lesion. No significant interval change in the size of the multiple other supratentorial and infratentorial metastatic lesions.   I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.