Clinical question: Status post tumor resection. Signs and symptoms: Status post craniotomy. Pre-and post-enhanced brain MRI:Examination demonstrates a large well-demarcated hemorrhagic mass and high convexity right posterior frontal lobe with large internal focus of enhancement. The combination of findings measures at 33 x 43 mm in transaxial dimensions. There is surrounding vasogenic edema and with resultant effacement of adjacent cortical sulci and trace deviation of midline to the left.Two tiny additional enhancing foci are metastatic lesion is also noted in the high convexity left posterior frontal and anterior parietal lobes with a larger lesion measuring only 4.5-mm in size. An additional small superficially located metastatic lesion approximately 4 mm is noted in the right posterior temporal -- occipital junction.Post-enhanced images also demonstrate a small developmental venous anomaly of the left frontal lobe.Calvarium demonstrate a tiny focus of enhancement in the left parietal (axial post enhanced series 1 to zero image 24 measuring approximately 4.5 mm. This finding demonstrate T2 hypointense signal pattern on axial T2 and T2 flair image 24 and could represent an additional metastatic lesion.Unremarkable images through the orbits. Mild extensive chronic sinusitis is noted. Its
1.Large hemorrhagic partially enhancing metastatic lesion in right posterior frontal measuring 43 x 33-mm in transaxial dimensions.2.Multiple additional subcentimeter metastatic lesions as detailed.3.4.5-mm focus of enhancement in the left parietal bone as detailed.