49-year-old female patient with weakness and history of brain metastases. There are postsurgical changes of a left frontal craniotomy for resection of a left frontal lobe intraparenchymal tumor. The resection cavity is smaller in size and contains a small amount of fluid with a thin T2 hypointense rim compatible with hemosiderin deposition. There is new circumferential enhancement of the resection cavity without nodularity or focal asymmetric thickening. Vasogenic edema within the left frontal lobe is markedly improved.Multiple additional enhancing lesions are significantly smaller in size or no longer visualized. For example a centrally cystic tumor within the left temporal lobe now measures 15 x 10 mm, previously 31 x 24 mm (image 11, series 1101). A solid tumor within the right medial temporooccipital lobe now measures 9 x 8 mm, previously 24 x 19 mm (image 14, series 1101). No new enhancing lesion is identified.A nonenhancing T2 hypointense extra-axial mass along the left cranial vertex, just posterior to the resection cavity, compatible with a calcified meningioma is unchanged.There is no evidence of acute infarct. Mild periventricular T2 signal abnormality may related to chronic small vessel disease or post-therapy changes. The ventricles and basal cisterns are stable in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. Bilateral maxillary sinus mucous retention cysts and a left sphenoid mucous retention cyst. There is partial opacification of the mastoid air cells. The orbits are grossly unremarkable.
1. Post-operative findings of the left frontal lobe with decreased size of the resection cavity but new circumferential enhancement; this is suspected to represent post-therapy change, however, the possibility of residual/recurrent tumor cannot be excluded. 2. Multiple additional metastatic lesions are smaller in size or no longer visualized.