History of small cell lung carcinoma with metastasis to the brain. There has been interval increase in size and number of numerous supratentorial and infratentorial metastatic lesions and associated vasogenic edema. For example, previously demonstrated lesion in the anterior left temporal lobe now measures 14 mm, previously 6 mm and a lesion in the superior vermis measures 13 mm, previously 4 mm. In addition, there are several new lesions in the cerebral and cerebellar hemispheres. For example, a new lesion in the left inferior temporal lobule measures 11 mm and a lesion in the right mid cerebellum measures 9 mm. Several of these lesions demonstrates leptomeningeal involvement. There is diffuse subcortical and periventricular white matter T2 hyperintensity. There is no evidence of acute intracranial hemorrhage. The ventricles and basal cisterns are unchanged 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.
1. Interval increase in size and number of supratentorial and infratentorial metastatic lesions with associated vasogenic edema.2. Diffuse cerebral white matter T2 hyperintensity is nonspecific, but may in part be related to treatment effects and/or small vessel chronic ischemic disease.I personally reviewed the Images and/or procedure with the Resident/Fellow and agree with this report.