69 years, Male, history of metastatic RCC to brain, status post SRS and WBRT. There is no significant change in size of treated, hemorrhagic lesion adjacent to the trigone of the left lateral ventricle measuring approximately 19 x 25 mm in the axial plane. There is mild peripheral enhancement which is not significantly changed.6 mm hemorrhagic right parietal lesion remains unchanged. There are unchanged additional foci of susceptibility effect related to chronic blood products at the site of prior lesions. Also unchanged postoperative appearance of the right frontal lobe resection bed including minimal curvilinear enhancement.No significant change in multifocal areas of FLAIR hyperintensity likely related to combination of posttreatment change and chronic small vessel ischemic disease. No new mass or mass affect. No new foci of abnormal enhancement to suggest disease progression in the brain. No hydrocephalus. No midline shift or herniation.Enhancing lesion involving the left masticator space demonstrates enlargement measuring approximately 19 x 18 mm, previously 14 x 10 mm.
1. Compared to 2/9/2016, there is no evidence of progression of metastatic disease in the brain. Multiple treated lesions are again seen, including a relatively larger left peritrigonal lesion.2. Enlarging soft tissue metastasis in the left masticator space.