History of small cell lung cancer with brain metastases treated with WBRT. There is a heterogeneously enhancing mass present along the medial aspect of the left temporal lobe currently measuring 19 x 13 mm axial dimensions and previously 27 x 13 mm axial dimensions. It is associated with T2 signal hyperintensity and some punctate foci of signal loss on susceptibility imaging. FLAIR signal abnormality associated with this particular lesion appears to have mildly regressed.A lesion located in the right medial temporal lobe patient's of the right lateral ventricle currently measures 15 x 15 mm axial dimensions and previously measured 8 mm axial dimensions. A lesion adjacent to the trigone of the left lateral ventricle at its junction with the temporal horn is not clearly visible on the prior exam but currently measures approximately 5 mm. Lesion located within the left hippocampus now measures 5 mm and previously measured 3 mm. FLAIR signal abnormality associated with these lesions appears to have increased.There is a cystic lesion present at the occipital horn of the left lateral ventricle which measures 10 x 19 mm axial dimensions. It has different signal intensity relative to CSF. On the prior exam it is not clearly distinguished. This particular lesion is associated with surrounding FLAIR signal hyperintensity.There several periventricular and subcortical punctate hyperintense white matter lesions present identified on the FLAIR and T2 images. These were also present on the prior exam.A lesion along the left occipital lobe lingual gyrus currently measures 20 x 11 mm and previously measured 6 x 7 mm.Normal vascular flow voids are present in the distal carotid and vertebral arteries, the basilar artery and the proximal anterior, middle and posterior cerebral arteries as well as the internal cerebral veins and superior sagittal sinus.The visualized portions of the paranasal sinuses demonstrate a small opacity in the left maxillary sinus. The visualized portions of the mastoid air cells are partially opacified. The visualized portions of the orbits are intact.
1.There are multiple lesions scattered within the brain parenchyma the majority of which have increased in size relative the prior exam. The exception is a lesion in the left temporal lobe which has mildly decreased in axial dimensions. These are compatible patient's diagnosis of metastatic disease2.A cystic lesion is present in the occipital horn of the left lateral ventricle which appears to potentially represent entrapment of the occipital horn.