Male, 60 years old, history of lung cancer metastases to the brain. Minimal if any residual enhancement is seen at the site of a previous lesion along the medial right occipital lobe, similar to the immediate prior examination and improved relative to examinations from August 2014. No reliably detectable enhancement is seen at the site of prior lesions in the right parietal lobe and the right middle frontal gyrus.No new enhancing lesions are seen. Mild periventricular T2 hyperintensity is seen along with a few scattered additional subcortical foci of white matter signal abnormality. Findings are nonspecific and unchanged. No parenchymal edema or mass effect is detected. No significant intracranial hemorrhage or any abnormal extra-axial fluid collections are seen. Ventricles are normal in size and morphology.Patchy nonspecific enhancement persists unchanged within the right parietal bone. Also noted is a 9-mm enhancing lesion which localizes along or within the left orbital roof (see image 14 of series 1001 and image 41 of series 1201). This lesion was not detectable on the first available brain MRI from 1/17/14, and has slowly increased in size on subsequent studies.
1. No definite evidence to suggest recurrent or new metastatic disease in the brain parenchyma.2. Note is made of a slowly growing 9-mm region of enhancement within or along the left orbital roof. The significance of this finding is uncertain and the differential diagnosis would include both a benign lesion, such as a hemangioma, as well as metastatic disease. Continued attention to this area on subsequent studies is encouraged.