43 years, Female, breast cancer with brain metastases. Surveillance.. There is evidence of progression of intracranial metastatic disease:There is a 5 x 5 mm right frontal lobe lesion which is new, series 1101 image 119. There is surrounding FLAIR hyperintensity/edema.There are 2 adjacent right occipital lesions measuring approximately 6 x 7 mm and 6 x 5 mm, series 1101 image 82, which appear to be along the cortical surface and possibly along the leptomeninges. There is associated FLAIR hyperintensity/edema in the right occipital cortex. There is a left cerebellar lesion, series 1101 image 57 which measures 9 x 6 cm, 3 x 3 mm previously on 4/12/2016. There is surrounding edema which is increased. There is punctate focus of susceptibility associated with this lesion with was present previously and may be related to blood products and/or mineralization.No significant intracranial mass effect associated with the above-mentioned small lesions. No evidence of acute ischemia or new hemorrhage. No midline shift or herniation. No hydrocephalus. There is an enhancing lesion involving the right frontal dura, suspicious for metastasis, series 901 axial image 29, and measures approximately 4 to 5 mm in thickness, and abuts the adjacent calvarium. No significant mass effect on the underlying brain. Several foci of intrinsic T1 hyperintensity in the bilateral frontal and parietal calvarium are also noted. No definite evidence of calvarial metastasis, which can be better assessed with bone scan.
Interval progression of metastatic disease with enlarged left cerebellar lesion as well as multiple new lesions, as described above. The right occipital lesions are along the cortical surface and may involve the leptomeninges. There also appears to be a small lesion along the right frontal dura.