Melanoma with new brain metastases on CT scan. There is a medial left cerebellar enhancing lesion that measures up to 18 mm, a left lateral cerebellar enhancing lesion that measures up to 10 mm, a left middle frontal gyrus enhancing lesion that measures up to 9 mm, a left superior frontal gyrus lesion that measures up to 6 mm, a left hippocampal tail enhancing lesion that measures up to 4 mm, and a right medial cerebellum enhancing lesion that measures up to 4 mm. There is confluent T2 hyperintensity surrounding the lesions. There is no evidence of intracranial hemorrhage or acute infarct. There is partial effacement of the fourth ventricle. The third and lateral ventricles are not particularly enlarged. There is no midline shift or herniation. There is mild scattered subcortical and confluent periventricular white matter T2 hyperintensity without associated enhancement. The major cerebral flow voids are intact. The orbits are grossly unremarkable. There is a subcentimeter exophytic cystic lesion in the skin along the left lateral eyelid region, which may represent a hidrocystoma. There is an apical scalp lipoma that measures 7 mm in thickness. There are small bilateral maxillary sinus retention cysts.
Multiple supratentorial and infratentorial metastases with vasogenic edema, but no midline shift or herniation.