Metastatic breast cancer with abnormality in the sphenoid area: difficulty concentrating and tremors. There is an unchanged enhancing lesion centered in the sphenoid triangle with epidural extension into the left middle cranial fossa that measures up to 5 mm in thickness, with mild mass effect upon the anterior pole of the temporal lobe and associated mild vasogenic edema. There is no evidence of intracranial hemorrhage or acute infarct. There is minimal periventricular white matter T2 hyperintensity, which is nonspecific. There is mild diffuse cerebral volume loss. The ventricles are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. There is mild mucosal thickening in the maxillary sinuses. There is a partially-imaged cystic lesion in deep lobe of the parotid gland that projects into the right parapharyngeal space that measures at least 15 mm. There are also multiple persistent subcentimeter cystic foci in the superficial portions of the right parotid gland. There are small scalp lipomas in the occipital region.
1. Unchanged lesion centered in the left sphenoid triangle with epidural extension into the left middle cranial fossa and associated mild vasogenic edema in the anterior temporal lobe.2. No evidence of intraparenchymal mass lesions, acute intracranial hemorrhage, or cerebral infarction.3. Multiple cystic lesions in the right parotid gland, which may be sequela of an inflammatory or autoimmune process versus a neoplastic condition, such as Warthin tumors. Follow up with dedicated parotid imaging may be useful if clinically warranted.