History of small cell lung cancer, with known brain metastases and seizure. There is an irregular peripherally-enhancing mass in the left anterior temporal pole that measures up to nearly 30 mm. There is extensive T2 hyperintensity and mild swelling throughout the left amygdala and hippocampus, with scattered punctate foci of faint enhancement. There is an enhancing nodule in the right fusiform gyrus that measures 8 mm in diameter, with surrounding confluent T2 hyperintensity. In addition, there is an enhancing lesion in the left occipital lobe that measures 6 mm in width, with surrounding confluent T2 hyperintensity. There is no evidence of acute intracranial hemorrhage or infarction. 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. The orbits, skull, paranasal sinuses, and scalp soft tissues are grossly unremarkable. There is a left anterior maxillary alveolus cystic defect.
Multiple brain metastases with associated vasogenic edema, the largest of which is located in the left anterior temporal pole. Diffuse swelling involving the amygdala and hippocampus with patchy foci of enhancement may be related to seizure activity associated with the metastatic disease.