Malignant neoplasm of unspecified kidney, except renal pelvis [C64.9], Reason for Study: ^Reason: Metastatic renal cancer, increasing dizziness, r/o brain mets History: dizziness There is replacement of fatty marrow of clivus with T1 low signal intensity lesion which shows mild enhancement on Gad. Similar lesions are seen on calvarium especially frontal bone. Considering multiple vertebral metastasis, these lesions could represent metastatic lesions. Thus, additional imaging study such as bone scan can be considered for further imaging evaluation.There is no evidence of acute ischemic or hemorrhagic lesion.There is no evidence of abnormal enhancement. The ventricles, sulci and cisterns are symmetric and unremarkable. There is no mass, mass effect, edema, midline shift, intra or extra-axial fluid collection/hemorrhage, restricted diffusion/acute ischemia, or abnormal contrast enhancement. The midline structures and cranial-cervical junction are normal. Normal flow voids are identified in the major intracranial vessels. The mastoid air cells are clear. Bilateral maxillary sinus retention cysts.
1. No evidence of acute ischemic or hemorrhagic lesion.2. No abnormal enhancement indicating brain parenchymal metastasis.3. Heterogenous bone marrow signal intensity involving clivus and skull as described above indicating possible metastatic lesions. Further imaging evaluation such as bone scan can be considered. 