48 years, Male, multiple myeloma. Brain: Compared to prior postcontrast brain MRI dated 4/28/2016, there has been marked decrease in size of the previously seen left posterior frontal intraparenchymal mass which measures approximately 8 x 9 mm on the current study and 21 x 25 mm on 4/26/2016. The decrease in size was also evident on prior noncontrast brain MRI dated 7/28/2016. Mild residual edema noted on 7/28/2016 has further slightly decreased in the interval. Nodular leptomeningeal enhancement in the left frontal lobe seen on 4/28/2016 has resolved. Enhancing mass in the pineal region measuring 22 x 26 mm on 4/28/2016 is also no longer discretely appreciable. Right frontal ventriculostomy catheter terminating in the right lateral ventricle is again seen. Ventricles are not significantly changed in size. There is however edema as well as mild enhancement near the distal aspect of the right frontal ventriculostomy catheter which was also present on prior MRI from 10/10/2016 but not on 4/28/2016. There is no discrete mass in this region.Previous seen small enhancing lesion seen on 4/28/2016 involving the right superior frontal gyrus as well as along the undersurface of the cerebellar vermis are no longer present. Small foci of susceptibility in the bilateral frontal lobes are compatible with chronic blood products or mineralization related to treatment change.No new enhancing lesion or mass is evident to definitively suggest progression of disease. No evidence of acute infarct or acute hemorrhage. No midline shift or herniation. No extra-axial collections.Cervical spine: The cervical spine is in normal alignment. The vertebral body and disk heights are well-maintained. The spinal cord is of normal caliber and signal. There is no significant disk bulge, herniation, spinal canal or foraminal stenosis within the cervical spine. There is no pathologic enhancement. STIR hyperintensity involving the C4 vertebral body adjacent to the basivertebral vein is nonspecific and similar to prior. There are mild degenerative changes including mild left C3-C4 neural foraminal stenosis. No high-grade spinal canal or neural foraminal stenosis is evident.
1. Multiple enhancing lesions in the brain have resolved or nearly resolved. There remains a 9 x 8 mm focus of enhancement involving the left precentral gyrus with susceptibility effect related to chronic blood products or mineralization related to treated lesion. No new or enlarging lesion to suggest progression of metastatic disease in the brain.2. Persistent edema and mild enhancement in the right posterior frontal lobe surrounding the ventriculostomy catheter, similar to 10/10/2016. Ventricles are stable in size without evidence of hydrocephalus.3. No appreciable myelomatous involvement in the cervical spine. 