28 years Female (DOB:3/26/1988)Reason: evaluate response to therapy in patient with metastatic breast cancer to brain. History: 3903PROVIDER/ATTENDING NAME: ANDREA LOUISE AMICO ANDREA LOUISE AMICO The CSF spaces are appropriate for the patient's stated age with no midline shift. On FLAIR MRI there is heterogeneous cortically based hyperintense lesion associated with heterogeneous contrast enhancement measuring 10 x 10 mm located along the medial aspect of the left paracentral lobule adjacent to the pars marginalis it previously measured 9 x 7 mm axial dimensions. The FLAIR signal abnormality is also larger on the current exam when compared to the prior exam.. Similar lesions are present in the right postcentral gyrus laterally where the enhancing component measures 10 x 15 mm axial dimensions and previously measured 12 x 9 mm. One in the right cerebellar hemisphere superiorly is also unchanged and measures 18 x 9 mm axial dimensions on other located in the right cerebellar hemisphere posteriorly and inferiorly measures 11 x 27 mm axial dimensions and is larger compared to prior exam when it measured 23 x 9 mm. Another lesion is present in the right occipital lobe measuring 10 mm x 6 mm axial dimensions along the inferior aspect of the cuneus previously measured 6 x 7 mm. Another is located along the right cingulate gyrus behind the splenium of the corpus callosum measuring 11 x 7 mm axial dimensions previously measured 7 x 11 mm. Another is located along the right superior frontal gyrus measuring 5 x 7 mm mm in diameter which previously measured 5 x 9 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 mucous retention cyst in the left maxillary sinus.. The visualized portions of the mastoid air cells are clear. The visualized portions of the orbits are intact.
1.Multiple cortical based lesions are scattered in both hemispheres of the brain as well as the cerebellum. These are compatible with metastases which have increased in size based on contrast enhanced imaging when compared to the prior exam.