Male, 62 years old, Reason: S/p SRS for brain mets. Surveillance exam. There is no evidence of progression of metastatic disease. A small hemosiderin stained resection cavity is again seen involving the left precuneus. No pathologic enhancement or new signal abnormality is detected in this vicinity. A 2 focus of enhancement within the left putamen with associated susceptibility effect is stable to minimally smaller since 9/6/2016 and particularly smaller when compared to earlier studies. No new enhancing lesions are seen. Scattered foci of nonspecific FLAIR hyperintensity within the cerebral hemispheres show no significant interval change. No evidence of acute ischemia. Diffuse prominence of the perivascular spaces is again seen. No abnormal extra axial collections are detected. The ventricles are stable in size and morphology.There is moderate degree of opacification involving the bilateral anterior ethmoid air cells and to a lesser degree the remainder of the paranasal sinuses, grossly similar to prior.
1. Postoperative findings in the left parietal lobe without evidence of local tumor recurrence.2. Minimal residual punctate focus of enhancement within the anterior left putamen corresponding to a treated metastasis. 3. No new or enlarging lesions to suggest progression of metastatic disease.