Metastatic lung cancer, brain mets, ALK+, on Ceritinib now. There are severe scattered supratentorial and infratentorial enhancing lesions. Some of these have not significantly changed in size, while others have increased in size. For example, a right medial temporal lobe lesion measures up to 11 mm, previously 8 mm, and a left occipital lobe lesion measures 7 mm in diameter, previously 4 mm, while a left superior cerebellar hemisphere lesion measures up to 6 mm, previously also 6 mm. There is negligible vasogenic edema associated with the lesions. There is no evidence of intracranial hemorrhage or acute infarct. The ventricles and basal cisterns are normal in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and scalp soft tissues are grossly unremarkable. There is a small right maxillary sinus retention cyst.
Some of the metastases have not significantly changed in size, while others have increased in size. 