Breast cancer and brain metastases; s/p SRS to R temporal lesion, L inferior frontal and L cerebellar lesions The dominant part of a left cerebellar mass measures 3.3 x 2.4 cm (series 10 image 23), previously 2.7 x 2.3 cm. There is now new diffusion restriction of the anterior left cerebellar region and increased susceptibility suggestive of hemorrhage. This is superimposed upon an enlarging anterior extending lobule of the tumor, in the area of the previously seen linear extension anterosuperiorly from the dominant component. This lobules now measures 2.1 x 2.1 cm (series 10 image 36). There is increased adjacent FLAIR signal abnormality extending across midline and mass effect.There is linear 7 mm residual enhancing tissue at the location of previous right temporal lobe lesion (series 11 image 18). There is minimal increase in a rounded right occipital intrinsically T1 hyperintense lesion with superimposed enhancement measuring 6 x 7 mm (series 10 image 91), previously 5 x 5 mm. Left frontal lesion is also minimally increased and measures 5 x 4 mm (standard image 105), previously 4 x 4 mm. There are areas of associated FLAIR hyperintensity.There appears to be interval mild global volume loss. No extra-axial fluid collections. Gray-white matter differentiation is preserved. Nonspecific mucosal thickening of the left maxillary sinus.
1.Increase in size, associated vasogenic edema, and localized mass effect of the left cerebellar metastasis with new hemorrhage anteriorly in an enlarging lobule of the mass.2.Minimally increased subcentimeter metastases, including ones in the left frontal and right occipital lobes.3.Near complete resolution of the right temporal lobe lesion with residual linear enhancing tissue, nonspecific but perhaps related to scarring.4.Findings discussed with Dr. Warnke pager 4244 by Dr. Stephanie Jo at the time of dictation.