69 years, Female, brain metastases. Examination for SRS planning. Examination is limited to sequences per radiation therapy planning protocol. Again seen is a heterogeneously enhancing mass in the right occipital lobe consistent with known metastasis and has enlarged. Lesion measures approximately 2.3 x 2.8 x 3.2 cm in the AP, transverse, and craniocaudal dimensions, previously 1.7 x 2.0 x 2.0 cm. Lesion now extends to the ependymal surface of the right occipital horn. There is evidence of hemorrhage within the lesion, which was seen previously. Surrounding vasogenic edema involving the right temporal, parietal, and occipital lobes has slightly increased since prior but not well assessed due to limited sequences. Mild effacement of the posterior aspect of the right lateral ventricle is similar to prior. No midline shift or uncal herniation. T1 hypointensity in the bilateral periventricular and subcortical white matter is compatible with chronic small vessel ischemic disease and/or posttreatment-related changes. Lytic lesion in the right temporal occipital calvarium with enhancement is again seen and appears to be present since CT 4/4/2014 and nonspecific.
Examination limited to sequences for radiation treatment planning. Compared to 3/9/2016, there has been mild enlargement of the hemorrhagic right occipital metastasis. There is also mild increase in surrounding vasogenic edema. No new lesions are appreciated.