Reason: Stage IV NSCLC s/ p SRS to left single occipital brain met History: Follow up imaging There is redemonstration of a small enhancing nodule in the left occipital lobe cortex, which is significantly decreased in size of a now only measuring 5 x 5 mm, previously up to 9 mm. There is again no significant associated FLAIR abnormality. There is also redemonstration of a small enhancing lesion which appears durally based along the right paramedian planum sphenoidale, again measuring 3 x 6 mm on 1201/145.The ventricles and sulci are within normal limits. The cisterns remain patent. There is no midline shift or mass effect. There are no new areas of abnormal signal or pathological enhancement. There is no diffusion abnormality. No extra-axial fluid collection is identified.Normal flow-voids are demonstrated in the major intracranial vascular structures. The midline structures and craniocervical junction are within normal limits. There is mild mucosal thickening within the visualized paranasal sinuses, with patchy opacification of the ethmoid sinuses as well as partial opacification of the right maxillary and sphenoid sinus.
1.Interval decreased size of enhancing lesion in the left occipital lobe cortex likely relating to treated metastatic disease2.Stable subcentimeter focus of extra-axial enhancement along the right planum sphenoidale which could relate to a small incidental meningioma. Continued attention to this finding on follow-up exams is recommended.3.Extensive paranasal sinus opacification as detailed above, worsened since prior exam. Please correlate clinically.