Metastatic small cell lung cancer with brain mets, on immunotherapy. There are postoperative findings related to right frontal craniotomy, with underlying confluent high T2 signal with encephalomalacia and susceptibility effect in the right frontal lobe, with an unchanged subcentimeter area of enhancement. Otherwise, there has been interval increase in size and number of multiple supratentorial and infratentorial lesions and associated vasogenic edema. For example, a left middle frontal gyrus lesion measures up to 12 mm in diameter, previously 6 mm, a right perirolandic lesion measures 20 mm, previously 9 mm, a left cerebellar lesion measures up to 14 mm, previously 7 mm, and a posterior medullary lesion measures 7 mm in diameter, previously 5 mm. In addition, there is a newly apparent anterior left frontal lobe lesion that measures up to 4 mm. Many of the lesions contain hemorrhagic components levels, some of which have evolved. There is no evidence of acute infarct. The ventricles and basal cisterns are unchanged in size and configuration. There is no midline shift or herniation. The major cerebral flow voids are intact.
1. Overall interval increase in size and number of multiple intracranial metastases with associated vasogenic edema.2. Postoperative findings related to right frontal craniotomy, with an unchanged nonspecific subcentimeter area of enhancement. 