History of known benign brain/calvarial tumor. Vision changes and motor impairment. There is a destructive calvarial mass involving the left greater than right parietal calvarium measuring 4.5 x 5.9 x 3.1 cm in the AP, transverse, and craniocaudal dimensions. Mass is predominantly low on T1 and T2 weighted images with small areas of cystic change and diffuse enhancement. There is mild mass effect on the adjacent brain parenchyma which includes the left pre and post central gyri. There is also mass effect on the adjacent cortical veins and superior sagittal sinus which is otherwise patent. There is an additional subcentimeter lesion which demonstrates T1 hyperintensity more inferiorly in the midline seen on the sagittal T1-weighted images. No additional enhancing calvarial lesions however are appreciated. Images of the brain parenchyma demonstrate no abnormal parenchymal or meningeal enhancement to suggest intracranial metastatic disease. No other intracranial mass or mass effect. No midline shift or uncal herniation. No extra-axial collections or hydrocephalus. Few scattered foci of T2/FLAIR hyperintensity are seen in the bilateral subcortical and periventricular white matter, which are nonspecific, but compatible with mild age-related white matter changes. Brain parenchyma is otherwise unremarkable for age. Major flow-voids are preserved. Sella and orbits are grossly unremarkable.
1. Destructive calvarial mass measuring 4.5 x 5.9 x 3.1 cm involving the left greater than right posterior parietal calvarium. There is mass effect on the underlying brain parenchyma which includes the medial aspect of the left pre and post central gyri. No associated intraparenchymal edema. Mass is reportedly benign per medical records and signal features are compatible with a benign osseous lesion such as fibrous dysplasia; recommend correlation with CT however to make this determination.2. No abnormal enhancement within the brain is seen to suggest intracranial metastatic disease.