Female, 52 years old, with metastatic renal cell carcinoma status post SRS on 06/16/16 to two adjacent right basal ganglia lesions. Evaluate for response/progression. The dominant hemorrhagic right basal ganglia lesion shows further interval accumulation of blood product, particularly along its superior margin. The lesion itself is stable to slightly reduced in size when compared to the pretreatment examinations. The lesion demonstrates intrinsic T1 hyperintensity related to blood product but no clear superimposed enhancement. A smaller right basal ganglia lesion located posterior and inferior to the dominant lesion shows interval development of susceptibility effect and resolution of previously seen enhancement. The degree of edema surrounding both these lesions has significantly improved.No new intracranial lesions are identified. The previously treated right cerebellar lesion demonstrates susceptibility effect with no evidence of associated edema or enhancement. Parenchymal morphology is otherwise within normal limits. No abnormal extra axial fluid collections are seen. The ventricles are normal in size and morphology.
The right basal ganglia lesions demonstrate expected post treatment findings. The dominant lesion shows progressive accumulation of blood product but stable to reduced overall size and reduced enhancement. The smaller adjacent lesion shows similar interval changes. Edema in the basal ganglia has significantly improved. The previously treated right cerebellar lesion is unchanged. No new lesions are detected.