Malignant neoplasm of esophagus, unspecified [C15.9], Reason for Study: ^Reason: 67 year old with esophageal adenocarcinoma and OSH report of brain met. Need to evaluate CNS involvement. History: na There was a 4.8 mm sized nodular enhancing lesion on the right occipital lobe. On today's scan, there is FLAIR high signal intensity at the same location within the right occipital lobe white matter, however, there is no evidence of contrast enhancement which is non specific. There is no other enhancing lesion seen on this scan. There is inhomogenous marrow signal intensity at C2 and C3 with minimal enhancement. This could represent normal variation of bone marrow signal intensity, however, if indicated dedicated cervical spine MRI can be considered for further imaging evaluation.There is no evidence of acute ischemic or hemorrhagic leison.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 paranasal sinuses and mastoid air cells are clear.
1. No evidence of abnormal enhancement.2. No acute ischemic or hemorrhagic lesion.3. FLAIR high signal intensity lesion on the right occipital lobe, non specific finding.4. Inhomogenous marrow signal intensity at C2 and C3.Comment: Regarding the enhancing lesion seen on prior out side MRI which is not seen on today's scan may need follow up imaging study. In addition, if clinically indicated, dedicated cervical spine MRI with and without contrast enhancement can be considered for further evaluation of the C2, C3 inhomogenous bone marrow signal intensity.