Stage IV thyroid cancer status post treatment. There are postoperative findings related to total thyroidectomy with vitamin E capsules positioned over the site of the surgical scar. There is ill-defined patchy enhancement within the thyroidectomy bed, but otherwise no evidence of discrete measurable mass lesions or significant lymphadenopathy in the neck. The upper aerodigestive tract and salivary glands are unremarkable. The osseous structures appear to be intact. The orbits are grossly unremarkable. There is a subcentimeter nodular focus of enhancement in the right paraspinal muscles at the level of C6 that appear continuous with the adjacent veins, which likely represent a prominent segment of vein. There is an enhancing nodule that measures up to 16 mm in the left cerebellar hemisphere with surrounding vasogenic edema.
1. Post-treatment findings without convincing evidence of recurrent tumor in the neck.2. A lesion in the left cerebellar hemisphere likely represents metastatic disease. A dedicated brain MRI would be useful for further evaluation of intracranial metastases.Discussed with Dr. Cohen at 4:25 PM on 7/24/15.