73 year-old female with a history of stage IIIC fallopian tube cancer. She underwent surgical staging in May 2006. She received IP Cisplatin followed by 5 cycles of IP carboplatin and IV Taxol completed in October 2006. She has been without evidence of disease since that time, and her CA 125 has been within normal limits. She has been treated for recurrent inflammatory lesions of the brain (atypical lymphoid infiltrates) responsive to oral steroids. There is new punctate enhancement in the cervical spinal cord, with additional punctate lesions suggested within the mid to left medulla. These findings may be related to the patient's prior inflammatory process in this region. There are stable postbiopsy findings in the left cerebellum with associated susceptibility artifact, likely related to chronic hemosiderin deposition. There is focal mildly increased ill-defined T2 signal in the left ventral pons and pontomedullary junction region, as well as a small focus of susceptibility artifact, not significantly changed since prior. Minimal scattered punctate foci of increased T2 signal in a periventricular distribution are also not significantly changed, and are nonspecific but commonly seen in the setting of chronic small vessel ischemic disease. The ventricles and sulci are prominent, consistent with moderate age-related volume loss. There is no midline shift or herniation. The major cerebral flow voids are intact. There is a small amount of fluid within the left mastoid air cells, as well as partial opacification of the bilateral ethmoid air cells and maxillary sinuses, with bilateral maxillary sinus air-fluid levels again seen, although improved from prior.
1. New punctate enhancement in the cervical spinal cord, with additional equivocal punctate lesions suggested in the middle. These findings may be related to the patient's prior inflammatory process in this region. Close imaging surveillance is suggested.2. Stable postbiopsy findings in the left cerebellum.3. Unchanged appearance of a focus of abnormal signal in the left pons, which may represent posttreatment changes or an underlying vascular malformation.4. Persistent opacification of the paranasal sinuses with air-fluid levels, although improvement is noted.