Female, 66 years old, history of metastatic breast cancer with progressive intracranial metastases. Please evaluate for radiosurgery planning. Findings are again seen related to prior left parieto-occipital craniotomy. Encephalomalacia of the underlying parenchyma appears similar to prior.An enhancing nodule within the right parietal lobe now measures 6 mm in diameter, previously 5 mm (image 117 series 501). Enhancing lesion along the inferior surface of the right cerebellum measures 7 x 6 mm, previously 6 x 6 mm (image 29 series 501). An enhancing focus within the primary cerebellar fissure on the right is unchanged (image 48 series 501).Two punctate enhancing lesions are identified within the right cerebellum, one of which is not significantly changed (image 50 series 501), while the other is new (image 47 series 501). A 6 mm enhancing lesion along the superior midline vermis (image 64 series 501), is new or at least significantly more conspicuous compared to the prior exam.Enhancement within the right IAC is unchanged. A developmental venous anomaly is redemonstrated within the pons. Three foci of susceptibility are evident within the pons the largest of which is in proximity to the developmental venous anomaly, all unchanged.
1. Slight increase in size of previously noted lesions in the right parietal lobe and inferior right cerebellum.2. New punctate lesion in the right cerebellar hemisphere, while two other small right cerebellar lesions are not significantly changed.3. New small lesion in the cerebellar vermis.