Female, 54 years old, with pancreatic cancer and new onset of difficulty speaking and spelling. A small resection cavity is evident within the left parietal operculum showing hemosiderin staining and mild intrinsic T1 hyperintensity. No concerning enhancement is seen within or adjacent to the cavity. Only minimal T2 hyperintense signal is evident surrounding the cavity. A 2 mm focus of enhancement within the left cerebellar hemisphere is new when compared to the prior examination. This lesion causes no detectable edema in the adjacent parenchyma.No other pathologic intracranial enhancement is suspected. A cavernoma with an associated developmental venous anomaly is again seen in the right parietal lobe showing no significant interval change. Scattered small foci of white matter T2 hyperintensity are seen perhaps representing chronic microvascular ischemic disease. No edema or mass effect is detected. No acute intracranial hemorrhage or any abnormal fluid collections are seen. The ventricles are normal in size and morphology.
1.Expected evolution of the left parietal opercular resection cavity with no suspicious signal abnormality or enhancement.2.A 2 mm focus of enhancement within the left cerebellar hemisphere is new and concerning for a focus of metastatic disease.3.Stable right parietal lobe cavernoma.