New diagnosis of adenocarcinoma of lung; staging MRI of brain. There are multiple, approximately 20, ring-enhancing supratentorial and infratentorial lesions. For example, the largest supratentorial lesion is located in the left occipital lobe and measures up to 18 mm and the largest infratentorial lesion is located in the right cerebellar hemisphere and measures up to 12 mm. There is no significant associated vasogenic edema and no evidence of acute intracranial hemorrhage. There is a background of mild scattered nonspecific foci of cerebral white matter T2 hyperintensive, but no evidence of acute infarct. The ventricles and sulci are mildly prominent diffusely due to cerebral volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. The orbits, skull, and paranasal sinuses are grossly unremarkable. There is a left occipital scalp lipoma that measures 5 mm in thickness.
Multiple supratentorial and infratentorial lesions are compatible with metastases, but no evidence of midline shift or acute intracranial hemorrhage.Discussed with Dr. Maitland at 11 AM on 5/13/15.