Female, 63 years old, with history of breast cancer. Baseline exam prior to starting on clinical trial. A 22 x 14 mm region of enhancing marrow replacement is evident within the right frontal bone. This correlates with an area of increased radiotracer uptake on prior bone scan. A lobular subcentimeter enhancing focus within the left parietal bone may simply represent a vascular space.Postcontrast images are degraded by motion artifact, but within this limitation, no definite pathologic parenchymal or extra-axial enhancement is seen. No evidence of active parenchymal edema is detected.Encephalomalacia is evident involving the right insula, basal ganglia and corona radiata with surrounding parenchymal T2 hyperintensity and mild associated susceptibility. Scattered additional foci of T2 hyperintensity are evident within the periventricular and subcortical white matter.No evidence of any acute intracranial hemorrhage is seen. No abnormal collections are detected. Ex vacuo dilatation of the right lateral ventricle is demonstrated. The ventricular system is otherwise within normal limits.
1.A lesion within the right frontal bone most likely represents a metastatic deposit, particularly given the nuclear medicine evidence for osseous metastatic disease elsewhere.2.Within the limitations of a motion degraded exam, no definite evidence of any parenchymal metastatic disease is seen.3.Chronic sequelae of right MCA distribution ischemia are demonstrated along with scattered lesions which likely reflect chronic microvascular ischemic disease.