History of NSCLC and brain mets status post crani and SRS to left posterior lesion in November 2014. Surveillance. Compared to 2/17/2015, there is no significant change in 6 x 8 x 10 mm peripherally enhancing lesion within the left occipital lobe which has been previously radiated. There is surrounding FLAIR hyperintensity which represent edema and/or gliosis and remains unchanged.Again seen are postoperative findings related to right frontoparietal craniectomy and cranioplasty with unchanged confluent T2/flair hyperintensity in the right frontal lobe. Small amount of chronic blood products. Multiple additional areas of T2/flair hyperintensity in the periventricular and subcortical white matter including the left basal ganglia are also unchanged. No new intracranial mass or mass-effect. No midline shift or herniation. No new enhancing lesions to suggest disease progression. No hydrocephalus. Enhancing lesion involving the right squamosal temporal bone does not appear significantly changed. No new calvarial metastases are appreciated. Interval improvement in mucosal thickening involving the left maxillary sinus.
1. No new lesions or new mass-effect to suggest disease progression. Compared to 2/17/2015, no significant change in 6x8x10 -mm peripherally enhancing left occipital lesion which has been radiated. Continued follow-up of this lesion is suggested.2. No significant change in enhancing right temporal osseous metastases.3. Postsurgical changes in the right frontal lobe without local disease recurrence.